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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700205
Report Date: 05/16/2022
Date Signed: 05/16/2022 12:11:15 PM

Document Has Been Signed on 05/16/2022 12:11 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:YOUNG FAMILY CHILD CAREFACILITY NUMBER:
367700205
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/16/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:23 AM
MET WITH:Johnnetta YoungTIME COMPLETED:
12:30 PM
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On 5/16/2022, Licensing Program Analysts (LPAs) Carol Heath conduct an announced pre-licensing inspection with the applicant, Johnetta Young to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety, and statutory requirements. The applicant is requesting to provide care for a small family childcare home with the capacity of 8 children. Currently, there are 3 adults (The applicant, her husband, and her adult daughter) and 2 children (5 and 16 yrs) living in the home. LPA toured the home in and out to ensure it meets FCCH requirements. Hours of operation are Monday through Friday, 5:00 Am to 11:00 PM. The incidental Medical Services (IMS) policy was discussed.

The home is described as follows:

This is a story home consisting of 4 bedrooms, 2 bathrooms, a kitchen, a living room, a Formal Living room/Dining Room, and a laundry room, The home has central heating and air conditioning. All windows are free of cracks, bugs, and debris. Hanging window blinds are cordless are inaccessible to the children.


Ø Indoor:
Main area: Main care is provided in the Living and Dining Room area. Children use the bathroom in the hallway. Children have access to the backyard.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2022
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
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· Living room and Dining Room: LPA observed age-appropriate toys books and equipment for children to play with. Age-appropriate toys and furniture were observed to be on the premises of this facility. All toys and furniture were observed to be in good condition during this inspection. A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the door with which children can play. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition. There is a TV that plays educational videos for the children and an adult-size couch.
· Family Room: In the family room a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children. In the family room, there were additional toys observed to be in the room stored in cubbies. LPA observed age-appropriate furniture and toys in the room. There are learning mats on the floor that are educational tools.
· Bathroom #1: Children will use bathroom #1 down the hall. Bathroom #1 was toured, and inspected medicine cabinet/toilet are in operable condition. Toilet and faucets are clean, safe, and operable; the bathtub and shower area is free of hazard. No medications storage in the medicine cabinet.
· Kitchen: All sharp utensils, cutlery, cleaning supplies, medicines; drawers and cabinets with plastic bags, and sharp things or small things children can swallow; are accessible to children without a child safety gate. The refrigerator dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. All lower cabinets in the kitchen have child locks. Medications are stored in the off-limits bedroom.
Ø Outside (Backyard): The backyard was inspected. The backyard is surrounded by a fence. Children will play outside in the backyard. There is an artificial grass area for active play. LPA observed toys and play equipment in good condition. The outdoor play area was observed to be free of hazards, and loose and sharp parts. Children play in the backyard. There is a grass area for active play. The left side yard has a gate for the dog and the right side yard is accessible to the child.

Ø Off-limit area:
· Bedrooms (Off-Limited) : (#1, #2, #3 and Master Bedroom) are off-limited. LPA observed the doorknob on the doors. Pre-applicant will lock all the bedroom doors during operation hours. LPA observed all the bedrooms to make sure the rooms are safe.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
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· Bathroom #2 (Master Bathroom): The bathroom was toured, and inspected medicine cabinet/toilet is in operable condition.
· Laundry room: The clean supplies and poison are in the laundry room. There is a safety lock that is made inaccessible to children. The laundry room is through a door (key locked & child locked) at the end of the hallway to the left. Cleaning compounds and detergents are in the laundry room. LPA observed (Padlock, deadbolt lock, Knob lock, or chain lock) to make the Landry room inaccessible to the children.
· Garage: LPA inspected the garage. According to The Applicant, the garage is off-limit for the children with the safety door lock. The garage is accessed through the laundry room and no childcare activities will be conducted there. LPA observed (Padlock, deadbolt lock, Knob lock, or chain lock) to make the Garage inaccessible to the children.
Ø Other:
ü A smoke detector and a carbon monoxide detector: The facility has one or more smoke detectors. The applicant needs to get a carbon monoxide device tested operable.
ü AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the unit.
ü Bodies of water: No Bodies of water in the facility. LPA did not observe any pool or other bodies of water.
ü Cleaning compounds are stored away in the laundry area and closet with a safety door lock inaccessible to children
ü Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
ü Fire extinguisher (2A10BC). LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 3/2022 and located in the kitchen inaccessible to children. It meets standards established by the State Fire Marshall.
ü Fireplace: The fireplace was observed in the off-limits living room and is screened.
ü Hanging window blind cords: The cords are accessible to children.
ü Incidental Medical Services (IMS): 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 of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
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The Applicant will not be providing IMS to the children at this time.
ü Isolation area (Illness): Per the applicant, if the child shows signs of illness, he/she will be separated from other children and stay in the Family Room.
ü Medications and cleaning solutions: Medications are in the off-limits bedroom.
ü Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 6 cots and 2 playpens in the closet.
ü Pet: 1 dog in this facility but not with daycare children.
ü The First Aid kit is located in the kitchen inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
ü Telephone Service: The applicant has a working landline or cell phone
ü Transportation: The applicant does provide transportation for children. The applicant has a valid California driver's license with an expiration date of 08/13/2024. The applicant has valid vehicle insurance with an expiration date of 08/19/22 and vehicle registration dated 03/10/23.
ü Weapons or Firearms: Per The Applicant, there are no weapons or firearms. LPA did not observe any weapons or firearms.
· Documentation:
The Applicant has current CPR, and First Aid Training with the expiration dates of 08/22, and Prevented Health and Safety Training completed: on 8/24/2020. The Applicant has her fingerprint clearance and TB exam. The Applicant has proof of being immunized against influenza, pertussis, and measles. The Applicant has proof of Mandated Reporting Training dated 05/11/2022. Per the applicant, she will provide transportation. Per Applicant, meals and snacks will be provided for children.
Ø LPA shared LIC 311D and all the required forms with the applicant.
Ø LPA reminds the applicant that CPR/First Aid (In-person) and Mandated Reporter Training need to be renewed every 2 years.
Ø The following information was discussed with the applicant :
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The applicant is reminded that 100% supervision is required for children at all times.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
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ü Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The applicant was reminded that supervision is always required for children in care.
ü The applicant was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The applicant was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.
ü The applicant was advised of the requirement to report unusual incidents and/or injuries (UIR) to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
ü The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
ü The applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
ü Criminal Record Statement: Applicant [or facility representative] 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 the 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.
ü Safe Sleep: LPA discussed the safe sleep regulations with the applicant [or facility representative] 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 the applicant [facility representative] 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
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ü Notice of Site Visit: A notice of a site visit was given and must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü Type A citation: LPA (name of analyst) informed applicant [or facility representative] (include name) that this report dated (insert visit date) document(s) (number of Types A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA (name of analyst) informed the applicant [or facility representative] to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) 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 this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
ü The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family daycare home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.
ü --The applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Applicant.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 05/16/2022
NARRATIVE
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********** Prior to being licensed the following is required: Due 5/20/2022 ***********

o The window blinds cords need to make inaccessible to the children.
o The applicant still needs to get her TDP result
o The applicant needs to get a carbon Monoxide


**As a result of this inspection, the home does not meet Title 22 Regulations. Corrections are required.


An exit interview was conducted and the report was reviewed with the facility representative Johnetta Young.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC809 (FAS) - (06/04)
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