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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364807607
Report Date: 05/24/2023
Date Signed: 05/24/2023 02:15:14 PM

Document Has Been Signed on 05/24/2023 02:15 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:BASSETT FAMILY CHILD CAREFACILITY NUMBER:
364807607
ADMINISTRATOR:BASSETT, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 534-1826
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Licensee, Cynthia Bassett TIME COMPLETED:
02:31 PM
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Licensing Program Analyst (LPA) Maddox met with licensee, Cynthia Bassett today for the purpose of conducting and unannounced Annual/Random inspection. Present today was licensee only. This is a 2 story home (barricade in place ) with 4 bedrooms, 2.5 bathrooms. All adults in the home (Licensee only) has a fingerprint clearance and exam for T.B. and required immunization's. **There are no pools, spas or any other bodies of water observed on the premises. The Main area of care is conducted in the family room (located next to kitchen). Children use the bathroom in hallway. Licensee also has an Infant Room and uses a portion of her Garage which has been converted and Grand fathered in for child care. Off limit areas include laundry room; garage and all the upstairs. Days and Hrs of Operation Mon - Fri 23.5 and some weekends.

The kitchen and bathroom (no cabinet underneath sink area and no medicine cabinet) were toured and inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects, all items were made inaccessible to children. All unused electrical outlets are plugged and play equipment and toys are available. There are age appropriate toys. Licensee is aware that baby walkers, bouncer, or any similar equipment are prohibited in any licensed facility.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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: BASSETT FAMILY CHILD CARE
FACILITY NUMBER: 364807607
VISIT DATE: 05/24/2023
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The backyard is completely fenced. No pets. There is a locked gate on the right side of the backyard that leads to the front of the home.

Licensee has current CPR and First Aid training (exp 5/2/2023). Per licensee, there are no weapons or firearms of any kind on the premises. Licensee's Mandated Reporter Training is current (exp 8/27/2023). The required fire extinguisher (2A 10BC), smoke detector, and carbon monoxide devises were are present and in operable condition. Licensee has maintained a current roster and has documented Emergency Disaster drills no less than twice a year.

The licensee is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.

There were no violations noted as a result of this unannounced Annual inspection. Home was found to be in substantial compliance with Title 22 Regulations.


The On Duty Worker is available for questions at 661-202-3318 Monday through Friday 8am-5pm. There were no violations of Title 22 Regulations noted. Copy of 811 (Confidential Names List) was provided during this inspection. Exit Interview conducted a copy of this report is discussed and left at the facility.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
LIC809 (FAS) - (06/04)
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