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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700080
Report Date: 01/29/2024
Date Signed: 01/29/2024 03:20:20 PM

Document Has Been Signed on 01/29/2024 03:20 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:BRASSFIELD FAMILY CHILD CAREFACILITY NUMBER:
367700080
ADMINISTRATOR:BRASSFIELD, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 202-2829
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
01/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee Linda BrassfieldTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Zirbes met with Licensee Linda Brassfield who guided analyst on a tour of the home for the One Year Required inspection. The child care space includes the Daycare room, family room, backyard, dining room, kitchen and the bathroom located within the day care room. The off limits areas are all three bedrooms, two bathrooms (located down the hallway), laundry room, and living room. The off limits areas were inaccessible via doors and baby gates. Currently living in the home are the Licensee, and two adults. All adults are associated and have eligible clearances. Current days and hours of operation are Monday through Friday 6:00am to 5:00pm. When LPA arrived LPA observed three infants in care with the Licensee providing supervision.

Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. LPA observed cleaning products and knives were stored in a high inaccessible shelf in the laundry room. Household medications were stored on a high shelf in the pantry. Per recorded documentation Fire/earthquake drills was completed in January 2024. The fire extinguisher was last serviced in April 2022. Therefore the fire extinguisher does not meet the State Fire Marshal standards, a type B citation was issued.

Safe and age appropriate toys, play equipment and materials were present. LPA observed a smoke detector and carbon monoxide detector in the home. The home has central heating and air conditioning, a portable heater was observed in the play room. The portable heater was not in use and was inaccessible to the children at the time of this inspection. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys were observed on the premises

Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080
VISIT DATE: 01/29/2024
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Report continued from page one

Per Licensee, there is one firearm in the home. Per LPA observations the firearm was stored in accordance with the regulations.

Bathroom (located near the play room): Toilet, sink, faucet were clean and operable. The following were inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish. During the walk through LPA observed Clorox cleaning wipes in a cabinet under the bathroom sink. The cabinet was not equipped with a child safety lock. The Clorox wipes were moved during this inspection. The children present at the time of the inspection were all in diapers and did not enter the bathroom during the inspection, Therefore, LPA provided the Licensee with an advisory notice regarding keeping cleaning products inaccessible to the children in care.

When LPA arrived to the childcare, LPA observed child 1 (C1) sleeping in a bassinet in the family room, LPA advised the Licensee that a bassinet is not an approved sleeping device for infant safe sleep. The only approved devices used for infant sleep in family child care homes are cribs or play yards that meet the United States Consumer Product Safety Commission safety (CPSC) standards, as noted in Regulation Section 102417(d)(1). In addition, C1 was observed sleeping on top of a folded blanket in the bassinet. Per Licensee, the blanket was added to make the space more comfortable for C1. LPA advised the Licensee that the cribs or play yard had to be free of all loose articles and objects. Two type B's citations were issued regarding infant safe sleep, refer to LIC 809D.

Outdoor: The entire back yard is on limits. During this inspection, the Licensee was only utilizing the side yard. The remainder of the backyard was inaccessible via a child safety gate. Per Licensee, small toys are brought into the area as needed for the children to play with. LPA observed an old toilet and yard tools in inaccessible outdoor play space. LPA advised the Licensee to ensure these items were inaccessible to the child care children if the additional on limits area was utilized for play. LPA reminded the Licensee to continually monitor the outdoor space to ensure all items which could pose a danger to children are inaccessible.

Per Licensee, the family has one dog. Per Licensee the dog does interact with the child care children.

Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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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: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080
VISIT DATE: 01/29/2024
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Report continued from page two

LPA reviewed five child files, the Licensees file and one assistants file (staff 1). Based on LPAs record review Child 2, did not have a child files on site. The Licensee only had emergency contact information for C2. A Type B citation was issued, due to the missing file, Refer to LIC 809D. Based on LPAs review, the staff files the Licensee file and staff 2 were missing documentation of the measles vaccination and Staff 1 files was missing the mandated reporter information. LPA advised the Licensee to ensure a copy of the vaccination information is added to the staff files, a advisory notice was issued. The Licensee CPR/First aid was current and expires in 09/17/24.
Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Documents Provided and/or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep.
The following were observed: Notification of Parents' Rights (PUB394), Roster (LIC9040), License, Emergency and Disaster Information (LIC610A).

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/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



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.


Report continued on page four
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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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: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080
VISIT DATE: 01/29/2024
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Report continued from page three

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-and-resources/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.

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 Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Based on LPAs record review there two technical advisory notices and four type B citations issued today, refer to LIC 809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Linda Brassfield.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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Document Has Been Signed on 01/29/2024 03:20 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 01/29/2024 at 12:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102352(p)(2)
Definitions
(2) "Play Yard" means a framed enclosure with integrated mesh or fabric sides that has not been banned or recalled by the United States Consumer Product Safety Commission.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when Child 1 was observed sleeping in a
bassinet. A bassinet is not an approved sleeping device for infant safe sleep, this poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/30/2024
Plan of Correction
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Per Licensee, the bassinet will no longer be used as a sleeping device. Only playyards or cribs will be utilized for the infants. The bassinet removed form the on limits space.
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above when per the fire extinguisher has not been serviced since April 2022, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/12/2024
Plan of Correction
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Per Licensee, the fire extinguisher will be serviced. Documentation will be submitted to the Department verifying the service was completed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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Document Has Been Signed on 01/29/2024 03:20 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 01/29/2024 at 12:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above when Child 1 was observed sleeping on top of a folded blanket in the bassinet, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/05/2024
Plan of Correction
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Per Licensee, blankets will not be added to the play yard or crib. The blanket was removed.
A video regarding safe sleep will be sent to the Licensee, the Licensee will submit documentation to the Department confirming the video was watched.
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.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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Created By: Kendal Zirbes On 01/29/2024 at 01:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BRASSFIELD FAMILY CHILD CARE
FACILITY NUMBER: 367700080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)
Admission Procedures and Parental and Authorized Representative's Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in one of three children (C2) present did not have a child file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/06/2024
Plan of Correction
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Per Licensee, the child will not be accepted into care until all required documentation is obtained from the authorized representative. If C2 is accepted into care a complete file will be created. Documentation the file has been created will be submitted to the Department.
Section Cited
Deficient Practice Statement
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2
3
4
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.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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