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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815675
Report Date: 01/20/2022
Date Signed: 02/28/2022 04:14:07 PM

Document Has Been Signed on 02/28/2022 04:14 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:PRICE FAMILY CHILD CAREFACILITY NUMBER:
364815675
ADMINISTRATOR:PRICE, CASEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 880-0316
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
01/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:12 PM
MET WITH:Casey PriceTIME COMPLETED:
03:31 PM
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Licensing Program Analyst (LPA), Maddox met with with licensee, Casey Price today for the purpose of conducting an unannounced Required 1 year inspection. Present today were licensee, 1 assistant, and 4 day care children. This is a 2 story with 4 bedrooms, 3 bathrooms. Family members residing in the home include licensee, her spouse, and 3 biological children. All adults in the home have fingerprint clearances and exams for T.B. LPA verified licensee has required immunization's. Main area of care is conducted in the family room; living room, 1 bathroom, and the backyard. Children use the 1 bathroom located downstairs. Off limit areas include the upstairs area (3 bedrooms and 2 bathrooms), laundry room, office, and storage closet.
Last Fire/Emergency Disaster Drill conducted 1/3/2022, CPR and First Aide exp 6/2022
LPA observed children wearing mask according the the LACPHD due to the COVID-19/Omicron variant,

All areas of the physical plant for child care were inspected. No violations noted.

The backyard was toured during this inspection, LPA did not observe any pools, spas or any other bodies of water on the premises and the yard is completely fenced.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PRICE FAMILY CHILD CARE
FACILITY NUMBER: 364815675
VISIT DATE: 01/20/2022
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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.
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.

******Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 o 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: http://www/ada.gov/childqanda.htm - No IMS at this time

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: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC809 (FAS) - (06/04)
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