364815803-12-17-2024-12-CC-KCAY-DC2V3X-20241217150528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364815803
Report Date: 12/17/2024
Date Signed: 12/17/2024 03:05:49 PM

Document Has Been Signed on 12/17/2024 03:05 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:	BROWN FAMILY CHILD CARE		FACILITY NUMBER:	364815803
ADMINISTRATOR/ DIRECTOR:	BROWN, MAYRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 245-6023
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	12/17/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:08 PM
MET WITH:	Mayra Brown		TIME VISIT/ INSPECTION COMPLETED:	03:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On December 17, 2024, Licensing Program Analyst (LPA) Calloway made an unannounced inspection to the above facility. LPA met with Licensee, who granted access. LPA and Licensee toured the home inside and outside for an Annual Random inspection. Residing in the home are the Licensee and spouse. The home is licensed for twelve to fourteen children. LPA observed seven daycare children in active care with licensee and representative during inspection. Ages nine months- 5 years old. Six kids were napping one infant was awake. All adults working and residing inside the home have a criminal record clearance and are associated to the facility. Physical Plant: This is a two story five-bedroom, four-bathroom home with kitchen, dining room, family room, living room, and garage. Childcare is provided: in the living room upon entry gated and the converted garage. Children’s Bathroom: is in hallway on the right it was observed to be clean, with soap and toilet paper, functioning sink and toilet and there were no shampoos, mouthwash, or visible hazards. The shower had storage supplies for the day care. The unused outlets in the home were covered. The blind cords were tied up high and made inaccessible. LPA observed age-appropriate toys, furniture, and books in good repair. There was napping equipment in the form of (cots, cribs, and playpens) and enough for all children in care. The home was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, hazardous conditions. The detergents and cleaning compounds are kept inside the laundry room that is locked.

Claretta Yates	TELEPHONE: (661) 202-3407
Kuliema Calloway	TELEPHONE: (661) 202-3381
	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364815803
	VISIT DATE: 12/17/2024

NARRATIVE

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The medicines are kept in the locked pantry. The windows are screened, free of bugs, cracks, and debris. There is a separate room for infants in Bedroom #1 that has a changing table, hand washing sink, diapers, supplies, and cribs for napping.
Inside the Kitchen, the items that can pose a danger to children were made inaccessible along with the sharp knives inside the locked pantry. Fire and earthquake drills were current, both drills were conducted on 11/16/24. The child and parent Roster was current and complete with all information. The required fire extinguisher (2A10BC) was full the needle was in the green area. The smoke and carbon monoxide detectors were tested as operable. The fireplace is screened, and the home has central AC and heat. The required postings were present on the parent board. There is a landline phone, and cell phone. The stairs were gated. The fire alarm pull switch was not observed inside the home. Per Licensee it is being ordered and will be installed. Licensee is aware an updated fire inspection is required. There was an infant in care that was not on the roster. Per Licensee, they thought the child was added and was able to add them during inspection. Off limit areas: Laundry room, Bedrooms: #2, #3, #4 and #5 Bathrooms: #2, #3, #4, loft, and laundry. Two areas in the yard are gated on the left and right.
Outside: The backyard is completely fenced. Pets: LPA observed one small pet dog. Per Licensee, the pet is vaccinated and does not interact with the day care children. There are toys, bikes, and play equipment. Per Licensee, there is no body of water on premises. LPA did not observe a pool, spa, or body of water on the premises. There were two AC units in the yard observed gated around. There were wood chips and grass for cushioning material and concrete for active play. There was a sandbox that was covered, and two little Tykes play apparatus’ with slides. There was one large shed observed unlocked. Licensee locked it during inspection. There was a small shed that was locked. There was a hand washing station that was empty without water.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364815803
	VISIT DATE: 12/17/2024

NARRATIVE

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Others: Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any in the home. Required mandated reporter training is current, CPR/First Aid (Exp: 1/21/2025), and immunizations were current. First Aid kit observed. LPA viewed staff and children’s files and reviewed all infants in care have LIC 9227 form in their files and an infant napping log. Per Licensee, none of the infant equipment has been recalled. LPA conducted a staff interview with the licensee. Transportation is provided. Incidental Medical Services (IMS) policy and Safe Sleep regulations were discussed. Per Licensee, the home has daycare liability insurance. The following was discussed with the Licensee:
Maintain capacity and transparency per posted parent rights, Roster requirements (keep updated information always and maintain information for three years), Documentation for disaster drills (fire and earthquake). Mandatory forms, signed, for the children’s/staff files, know updated Safe Sleep regulations. The role and responsibilities of being a mandated reporter. Supervision is always required for children in care. If food is brought in, it is properly labeled. Check food expiration dates periodically. Responsible for knowing the regulations as well as anyone who assists in providing care. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. If day care is closed for the day, no kids show, or Licensee absent, must notify Licensing. Inaccessibility of hazards must be constantly reassessed depending on the children in care. If the phone number is changed, licensing must be notified. Regulations prohibit the smoking of tobacco in a private residence that is licensed as a family childcare home and areas of the day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exer saucers, and any other items that fall into that category. 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 Childcare Home.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364815803
	VISIT DATE: 12/17/2024

NARRATIVE

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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.
Type A deficiency: Type A deficiency shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is an immediate risk to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A deficiency to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of the Type A report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) must be placed in the child's file for verification of the Type A deficiency. Failure to do so will result in a civil penalty being assessed.
--Licensee is advised to visit: www.shotsforschool.org for Immunization information.
--Licensee was informed of their responsibility to report suspected Child Abuse (LIC 9108), 1-800-827-8724/760-243-6640. Licensee was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
--Family Child Care Providers (Disaster Planning information):
https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Child Care Videos: https://ccld.childcarevideos.org
--Licensee advised to visit the CCLD website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364815803
	VISIT DATE: 12/17/2024

NARRATIVE

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--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 prior to providing the IMS. 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: http://www.ada.gov/childqanda.htm.
--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.
--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.
--Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364815803
	VISIT DATE: 12/17/2024

NARRATIVE

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Reminder: The On- Duty Worker is available for questions at: (661) 202-3318 (Monday-Friday 8am-5pm) and for reporting Unusual Incident Reports (within 24 hours). Written Unusual Incident Reports are sent (using (LIC 624 form) to the following email address: unusualincidentreport@dss.ca.gov within seven (7) days after reporting the incident via telephone.

Per Title 22 Regulations, there were no deficiencies cited during this inspection. There are two Technical Violations and one Technical Advisory issued during the inspection. See TV/TA pages attached to this report.

An exit interview was conducted, a copy of this report was read, and a Notice of Site Visit, were provided to Mayra Brown, Licensee during the inspection. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain the posting will result in $100 civil penalty. 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.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

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