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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844573
Report Date: 05/21/2024
Date Signed: 05/21/2024 01:23:46 PM


Document Has Been Signed on 05/21/2024 01:23 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BROWN FAMILY CHILD CAREFACILITY NUMBER:
364844573
ADMINISTRATOR:BROWN, DELANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 881-3291
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY:14CENSUS: 4DATE:
05/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Delana Brown-LicenseeTIME COMPLETED:
01:40 PM
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On May 21ST 2024, Licensing Program Analyst (LPA) Sherell Braddock met with Licensee, who granted access. LPA toured facility with the Licensee for an Annual Random inspection. This is a single story 4-bedroom, 2-bathroom home with kitchen, dining, living room, formal dining room, laundry room and garage. Upon arrival LPA observed 4 daycare children napping. There is no pool/spa or body of water on the premises. Family members residing in the home include 1 adult (licensee) and no children. Incidental Medical Services (IMS) policy was discussed. Operating hours are twenty-three hours a day. Licensee was advised that a staff member must always be awake while children are in care (for 23-hour operation). Transportation is not provided.

Main childcare is provided in the living and formal dining room (at entrance). Children use the bathroom in hallway on the left. Off limit areas include Bedroom #2, #3, Bathroom #2, laundry (key lock) and garage (key lock). The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (laundry room- locked), medicines – Licensee states that she does not have any medication on the premises and hazardous items (sharp knives in upper cabinet of kitchen) that can pose a danger to children. Fire/earthquake drills complete and maintained current. Roster complete and maintained current. There is a landline and cell phone for use. LPA did not observe any pets.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR NAME: Sherell BraddockTELEPHONE: (661) 202-3412
LICENSING EVALUATOR SIGNATURE:
DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364844573
VISIT DATE: 05/21/2024
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The backyard is completely fenced. Outside has dirt and concrete for play. Age-appropriate bikes and play structures were observed and anchored into the ground

Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any weapons in the home. There are age-appropriate toys and napping (cots, playpen) equipment. The required fire extinguisher (2A10BC) and smoke detector and carbon monoxide detectors were tested and are in operable condition. There is no fireplace. Home has central AC and heat. AC Unit in the front of the home (gated). The First Aid kit was observed and is complete. Staff and Child files were reviewed. CPR/First Aid were observed current. Mandated Reporter training is current. Required postings were observed on the wall.

The required posted documents were posted and located in the entry way to the right: Notification of Parent's Rights Poster (PUB394), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC9148).

The following was discussed with the licensee:

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR NAME: Sherell BraddockTELEPHONE: (661) 202-3412
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364844573
VISIT DATE: 05/21/2024
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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.

The licensee was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, licensees, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR NAME: Sherell BraddockTELEPHONE: (661) 202-3412
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364844573
VISIT DATE: 05/21/2024
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 Licensee must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition, or construction.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead

Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR NAME: Sherell BraddockTELEPHONE: (661) 202-3412
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364844573
VISIT DATE: 05/21/2024
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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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The licensee was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

LPA confirmed that there are no Registered Sex Offenders living in the facility and completed the RSO profile in FAS during the file review.

This inspection visit was conducted in person. The report was read, and a copy was provided to the licensee, Delana Brown. Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR NAME: Sherell BraddockTELEPHONE: (661) 202-3412
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
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