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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364808486
Report Date: 12/27/2024
Date Signed: 12/27/2024 02:53:38 PM

Document Has Been Signed on 12/27/2024 02:53 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:FOWLIE-PETERS FAMILY CHILD CAREFACILITY NUMBER:
364808486
ADMINISTRATOR/
DIRECTOR:		FOWLIE-PETERS, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 951-5770
CITY:VICTORVILLESTATE: CAZIP CODE:
92395
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
12/27/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:52 AM
MET WITH:Linda Fowlie-PetersTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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On 12.27.24, Licensing Program Analyst (LPA) Kris Diaz conducted an unannounced inspection at the facility, LPA was greeted by Licensee, Linda Fowlie-Peters who granted access and guided LPA on a tour. The purpose of the visit was to follow-up on an Unusual Incident that was received at Palmdale RO on 12.13.24. Upon arrival LPA observed 12 children in care with the licensee including one infant. Per licensee, parent of 4 dropped off kids today that were not expected. Licensee contacted helper to come help. LPA advised licensee to contact parent of children and ask her to come get the children. Licensee's helper/volunteer Sophia Arvayo arrived at about 12:40 PM. LPA conducted a safety inspection that resulted in 1 deficiency due to non-compliance of staffing ratio and capacity.

During the inspection LPA conducted confidential interviews and gathered documents pertinent to the investigation of the incident. As reported on 12.13.24 C1 sustained an injury requiring medical attention. The incident occurred on 12.6.24 and was reported to RO on 12.13.24. Due to the holidays, parties pertinent to the investigation were not present and must be interviewed at a later date.

During the inspection, LPA issued 1 Type A and 2 Type B citations (See LIC809-D). LPA reminded licensee that she must provide a copy or ensure that a parent of each child enrolled reads this report and signs an LIC9224 for each child. Due to licensee's non-compliance LPA suggested help from the Technical Support Program (TSP). Licensee agreed that she would like to be referred to the program. LPA will send referral upon return to RO.

This inspection was conducted in person. LPA read and provided a copy of this report to the licensee, Linda Fowlie-Peters which must be posted for 30 days. LPA provided Appeal Rights and a Notice of Site Visit which must be posted for 30 days.
Claretta YatesTELEPHONE: (661) 202-3407
Kristina DiazTELEPHONE: (661) 202-3372
DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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Document Has Been Signed on 12/27/2024 02:53 PM - It Cannot Be Edited

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: FOWLIE-PETERS FAMILY CHILD CARE
FACILITY NUMBER: 364808486

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/27/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
102416.5 Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
Deficient Practice Statement
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POC Due Date: 12/30/2024
Plan of Correction
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Licensee contacted helper to come assist in the facility. Assistant arrived at approximately 12:40pm putting the licensee's ratio in compliance. Licensee will watch the following video: https://ccld.childcarevideos.org/family-child-care-providers/how-many-children-can-attend-a-family-child-care-home/
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 YatesTELEPHONE: (661) 202-3407
Kristina DiazTELEPHONE: (661) 202-3372

DATE: 12/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/27/2024

LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 12/27/2024 02:53 PM - It Cannot Be Edited

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: FOWLIE-PETERS FAMILY CHILD CARE
FACILITY NUMBER: 364808486

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/27/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
102416.2 Reporting Requirements
(a) The licensee shall report the following information to the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). (3) Health and Safety Code Section 1597.467(b)(1)
Deficient Practice Statement
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POC Due Date: 01/03/2025
Plan of Correction
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Based on observation, interview, and record review licensee contacted the office OD (LPA Diaz) on 12.13.24 to report an incident that occurred on 12.6.24. This is a potential health, safety, and personal rights risk to the children in care.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
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 YatesTELEPHONE: (661) 202-3407
Kristina DiazTELEPHONE: (661) 202-3372

DATE: 12/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/27/2024

LIC809 (FAS) - (06/04)
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