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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700827
Report Date: 05/20/2025
Date Signed: 05/20/2025 01:07:10 PM

Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MCCAREY FAMILY CHILD CAREFACILITY NUMBER:
197700827
ADMINISTRATOR/
DIRECTOR:		ANDREA MCCAREYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 252-5089
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
05/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:36 AM
MET WITH:Licensee/ Andrea MccareyTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On 5/20/2025, Licensing Program Analysts (LPAs) Carol Heath and Ana Rodriguez conducted an unannounced annual inspection at McCarey Family Child Care. Upon arrival, LPAs were greeted by the licensee, Andrea McCarey, to ensure the facility meets licensing requirements. The licensee is requested to provide care for a large family childcare home with a capacity of 14 children. LPA toured the house in and out. Individuals who reside in the home include two adults (licensee and licensee’s daughter) and one grandchild (daughter, 3 years old). Per Guardian, all adults in this facility obtain a criminal record clearance and are associated with the facility.

During today's inspection, 2 infants (11 months) and 4 children (3, 3, 2 and 2 years old) were with the licensee and the assistant (daughter). The licensee's hours of operation are Monday through Sunday, 23 hours. The incidental Medical Services (IMS) policy was discussed. The licensees will not provide IMS at this time.

The home is described as follows:

This two-story home comprises 5 bedrooms and 4 bathrooms, a kitchen, a Bonus room, a Den, a living/dining room, a laundry room, and a garage. There is no body of water on the premises. Children can access the backyard and kitchen.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 12
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited


Created By: Carol Heath On 05/20/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, When LPAs arrived to the facility, a 11 months infant was sleeping with a blanket. According to the licensee, the blanket is for babe's comferting and relax himself, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/20/2025
Plan of Correction
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The licensee removed the blanket after LPAs shared the information. The licensee agreed to share the inforamtion with parents and will not put the blanket on the infant anymore.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Carol Heath
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited


Created By: Carol Heath On 05/20/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, During today’s inspection, LPAs observed sharp utensils (knifes) were on the kitchen counter, pizza cutter in the drawer, cleaning supplies are under the kitchen sinks and the safety latch is broken. Personal medicines are in the kitchen cabinet without a safety latch. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/27/2025
Plan of Correction
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The licensee agreed to fix the safety latches and put all the poisons, detergents, medicines with safety latches or make them inacessible to the childcare children.
Type B
Section Cited
CCR
102417(g)(4)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, During today’s inspection, LPAs observed sharp utensils (knifes) were on the kitchen counter, pizza cutter in the drawer, cleaning supplies are under the kitchen sinks and the safety latch is broken. Personal medicines are in the kitchen cabinet without a safety latch. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/27/2025
Plan of Correction
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The licensee agreed to fix the safety latches and add other safety equipemnts to make poisions, cleaning compounds and medicines inaccessible to the children.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Carol Heath
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
Page: 4 of 12
Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited


Created By: Carol Heath On 05/20/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above, LPAs observed 2 playpens have regular blankets as the sheets, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/20/2025
Plan of Correction
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The licensee removed the blankets and she understood the safety sleeping regulation.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation,interview and record review, the licensee did not comply with the section cited above, LPAs observed 2 infants did not have 15 minutes logs in their files. According to the licensee, she forgot to fill them out, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2025
Plan of Correction
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The licensee will out the logs and start checking and loging the 15 minutes when the infants are going to sleeping until the infants turn 2 years.
The licensee will email the logs on 5/23/25. And keep them in the file.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Carol Heath
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
Page: 5 of 12
Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited


Created By: Carol Heath On 05/20/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above, During today's inspection, the licensee and her assistant did not renew their mandated reporter training,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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The licensee agreed to complete the mandated reporter training with her assistant and email the certifications to the LPAs by 5/30/2025,
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, during the inspection, the licensee was unable to provider her assistants' immunication records,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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The licensee agreed to get the assistants shot records and email to LPAs by 5/30/2025
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Carol Heath
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
Page: 6 of 12
Document Has Been Signed on 05/20/2025 01:07 PM - It Cannot Be Edited


Created By: Carol Heath On 05/20/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, During today's inspection, the licensee was unable to provide her assistant's file for review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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The licensee will create assistants' files for each assistant. The licensee agreed to email LPA all the requirement documentations
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review)], the licensee did not comply with the section cited above, during today's inspection, LPAs did not observe the LIC 9227 in 2 infants' files. According to the licensee, she forgot to ask parents to fill out, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2025
Plan of Correction
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The licensee agree to print out LIC 9227 and ask parents to fill them out. The licensee will email them to LPA by 5/23/2025 (Friday).
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Carol Heath
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
Page: 7 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827
VISIT DATE: 05/20/2025
NARRATIVE
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Main area: Main care is provided on the First floor; Bedroom #1 (downstairs), the Family, Dining, and Living rooms are used for childcare. Children use the bathroom next to Bedroom #1 on the right in the hallway. Family Room/Dining room/Living room/Bedroom #1: An electric fireplace in the Living room is screened to make it inaccessible to the children. LPA observed some age-appropriate toys, books, and other materials in the Dining room area. Per the licensees, the children will nap in the Family Room and bedroom #1. During the inspection, LPAs observed a 11-month-old baby was sleeping in the crib with a blanket. 2 other playpens have blankets on the bottoms as the sheet.
Bathroom #1: Children will use the bathroom next to bedroom #1. Bathroom #1 was toured and inspected. The toilet and faucets are clean, safe, and in operable condition. The bathtub and shower area are free of hazards.
Kitchen/Dining: During today’s inspection, LPAs observed sharp utensils (knifes) were on the kitchen counter, pizza cutter in the drawer, cleaning supplies are under the kitchen sinks and the safety latch is broken. Personal medicines are in the kitchen cabinet without a safety latch. Several alcohols are in the hallway cabinet without safety latch. A bottle of wine is in the refrigerator. The refrigerator, dishwasher, stove, microwave, etc., are clean.
The backyard was inspected outside. It is completely fenced (brick). The patio and the left-side outdoor area are accessible to the children. LPAs observed a BBQ grill without a cover. The licensee was reminded to supervise children while playing in the backyard.
Off-limit area: The areas include the second floor, bedrooms 2 to 5, bathrooms 2, 3, and 4, laundry (safety knob), and garage (Safety doorknob).
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 8 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827
VISIT DATE: 05/20/2025
NARRATIVE
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Other:
The AC/Heating unit was observed on the right side of the home. This unit is effectively secured with barrels to block child access. The facility was free from bodies of water, as confirmed by the licensee and the LPAs.
Some unused electrical outlets throughout the facility were unplugged. The licensee will need to make them inaccessible to children. The licensee has committed to enrolling in the Food Program and will provide all meals, including breakfast, lunch, snacks, and dinner. A fire extinguisher rated 3A10BC was present in the kitchen. It was found to be fully charged, with a reading in the green, and meets the standards set by the State Fire Marshal. Hanging window blind cords have also been properly secured and are not reachable by children. The isolation area for children showing signs of illness is designated in the family room. Supervised nap times are supported by the presence of 12 cots stored in a closet, ready for use. The licensee does not currently provide overnight care. Additionally, no pets are on the premises. An active landline or cell phone assures reliable communication. Smoke detectors and carbon monoxide devices were tested and found to be fully operational, meeting essential safety requirements. A complete first aid kit, including a manual, is securely stored in a locked closet. The licensee will provide transportation services for school-age children. The licensee confirmed that the facility has no firearms on the premises.
Documentation:
The licensee has current CPR and First Aid Training with expiration dates of 2/24/2027 and Prevented Health and Safety Training completed on 5/19/2024. She has her fingerprint clearance and TB exam. She has proof of being immunized against influenza, pertussis, and measles. She has proof of Mandatory Reporting Training expiration dated 3/18/2025. LPA shared LIC 311D with the licensee.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 9 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827
VISIT DATE: 05/20/2025
NARRATIVE
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Child Files: LPA reviewed 5 children's records. A file is missing (LIC 627), a file the parent did not sign LIC 995A and 2 children do not have sleeping log and sleeping plan. Two infants are missing LIC 9227and sleeping logs. LPA shared information about Safe Sleep Regulations with the licensee.
Staff Personnel File: During the inspection, LPA reviewed 1 staff file (daughter), The licensee was unable to provide any documentation for the assistant.
Mandated Reporter Training: The licensee and her assistant will need to complete the online mandated reporter training at www.mandatedreporterca.com, which expires on 3/2025.
Facility Fees: According to the Licensing Information System, the annual facility fees are current.
Fire/Disaster Drill: The licensee conducts fire and disaster drills every six months, with the last drill documented on 04/2025.
Required Postings: LPA observed that the licensee has the Facility License, Emergency Disaster Plan, Earthquake Preparedness, and Parents' Rights Poster displayed as required.
The following information was discussed with the licensee:
ü LPA discussed the safe sleep regulations with the licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and- resources/safe-sleep as an additional resource. LPA also informed the licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 10 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827
VISIT DATE: 05/20/2025
NARRATIVE
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ü Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
ü IF A FACILITY IS CURRENTLY PROVIDING IMS, USE AS FOLLOWS: This facility provides Incidental Medical Services – IMS. LPA reviewed the storage of medication and equipment/supplies and reviewed children’s, personnel, and administrative records. For IMS information, see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/
ü IF THERE IS NO CHILD AT THE FACILITY THAT CURRENTLY NEEDS IMS, USE AS FOLLOWS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
ü Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 11 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MCCAREY FAMILY CHILD CARE
FACILITY NUMBER: 197700827
VISIT DATE: 05/20/2025
NARRATIVE
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ü Family Child Care Homes During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
ü Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.
ü To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send an email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-carelicensing/ inspection-process.

Deficiencies cited: (See LIC 809D). The following Type A and B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

An exit interview was conducted, and the report was reviewed with the licensee, Andrea McCarey.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 12 of 12