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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804106
Report Date: 05/23/2024
Date Signed: 05/23/2024 02:16:47 PM

Document Has Been Signed on 05/23/2024 02:16 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:HALL FAMILY CHILD CARE HOMEFACILITY NUMBER:
364804106
ADMINISTRATOR/
DIRECTOR:		PAULA HALLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 401-7018
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
05/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Licensee Paula Hall TIME VISIT/
INSPECTION COMPLETED:
02:25 PM
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On May 23, 2024, at 10:10 a.m., Licensing Program Analyst (LPA) Zirbes met with Licensee Paula Hall who guided analyst on a tour of the home for the Annual/Random inspection. Upon arrival, LPA observed twelve children in care (1 infant, 11 over the age of two) with the Licensee and Adult 1 (A1) providing supervision. During LPAs inspection, two additional school age children arrived and one preschool child was picked up. Based on LPA observation, the child care was meeting the staffing/ratio requirements at the time of this inspection. According to the Licensee currently living in the home are the Licensee and Adult 2 (A2). All adults are associated and have eligible clearances. Current hours of operation are Monday to Friday 6:00am -5:30pm.
Physical Plant: This is a single story house with three bedrooms, three bathrooms, kitchen/dining room, living room, daycare room, and backyard. Per Licensee the day care room, bedroom 2, bathroom 2 (located outside of bedroom 2), bathroom 3 (located in day care room), living room, dining room/kitchen and the backyard are utilized for the family child care activities. Per licensee off-limit areas of the home are the master bedroom, master bathroom, and bedroom 3 (utility room/laundry room). The off limit areas of the home were inaccessible via locked doors.
The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. During the inspection, LPA observed cleaning products were stored in the cabinet under the kitchen sink. The cabinet was equipped with a magnetic child safety lock. Per Licensee, zero medications are currently being provided to the child care children. Knives and sharp items were stored in a high inaccessible kitchen cabinet. LPA observed a smoke detector and carbon monoxide detector in the preschool room. A fire place was in the living room, per Licensee the fire place is not utilized and is made inaccessible via a ottoman placed in front of the fireplace. LPA did not observe baby bouncers/saucer chairs, or any recalled and or prohibited toys on the premises. Per Licensee, there are zero firearms or weapons stored in the family child care. Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 05/23/2024
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Report continued from page one

During the tour of the home the Licensee shared that Child 2 (C2) age four, occasionally sleeps in a play yard due to special needs. The use of the play yard is in agreement with the parent. LPA advised the Licensee to ensure the play yard currently being used by C2 meets the manufactures requirements for height and weight. Licensee agrees to review the manufactures paperwork and if C2 exceeds the height and weight requirements a new sleeping environment will be obtained. A technical advisory notice was issued. In addition, LPA observed a mattress inside the play yard utilized by child 1 (C1). LPA observed an approximate inch gap between the side of the mattress and the play yard. Based on LPA observation, the mattress was not made specifically for the size of the play yard. LPA did not observe an infant inside the play yard. LPA and Licensee discussed safe sleep and the mattress was removed during this inspection. A technical advisory notice was issued.
According to the documentation on the fire extinguishers located in the day care room and in the entranceway the fire extinguishers were last serviced in November 2022. Therefore the fire extinguishers were not serviced within the year and do not meet the State Fire Marshall standards. A type B citation was issued, refer to LIC 809D.

Bathrooms (located in the preschool room and hallway): Toilet, sink, shower/tub were clean and operable.

Outdoor: The outdoor activity space consists of on limit and off limit areas. The designated outdoor play area is located off the day care room. The outdoor activity space was enclosed by a chain link fence. The off limit area was inaccessible via a locked gate. LPA observed dramatic play houses, multiple little tikes climbing structures. LPA observed approximately four piles of dog droppings in the outdoor play space. When LPA arrived the children were playing in the outdoor play space. However, LPA did not observe the children playing in areas within a close proximity to the droppings therefore a Type B citation was issued. Refer to LIC 809D.

Per Licensee, there is one dog on the property who interacts with the child care children.

LPA reviewed five child files, the Licensees file and one assistant file. Per LPA review, one of five child files (C1) reviewed was missing documentation of their immunization's. A technical advisory notice was issued. staff files contained the required documentation. Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 05/23/2024
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Report continued from page two
During the inspection LPA and Licensee discussed the requirement for Large Family Child Care homes to have single action door handles on exit doors. Based on LPA observation and conversation with the Licensee the exit doors are not equipped with single action door handles, therefore a advisory notice was issued.

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The following was discussed with the licensee:


Licensee 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/
safe-sleep as an additional resource. LPA also informed licensee 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.

Licensee 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.

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/.

Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/23/2024 02:16 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 05/23/2024 at 01:03 PM
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: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

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 approximately four piles of dog droppings were in the outdoor activity space, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2024
Plan of Correction
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The outdoor activity space was cleaned up immediately. Per Licensee, the outdoor activity space will be inspected prior to the children going and playing outside.
Type B
Section Cited
CCR
102417(g)(1)
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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above when the fire extinguisher was serviced in November 2022, which does not meet the State Fire Marshall standards and poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2024
Plan of Correction
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Per Licensee, the fire extinguisher will be serviced and the Licensee will make a plan to ensure the fire extinguisher is serviced each year to meet the State Fire Marshall standards
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2024


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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 05/23/2024
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Report continued from page three

During the exit interview, the Licensee Paula Hall, confirmed that there are no Registered Sex
Offenders living in the facility and LPA completed the RSO profile in FAS.

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 email inquiries 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-care-licensing/inspection-process.

As a result of this inspection, two type B citations were issued along with five advisory notices.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Paula Hall.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
LIC809 (FAS) - (06/04)
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