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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700205
Report Date: 10/04/2023
Date Signed: 10/04/2023 02:07:06 PM

Document Has Been Signed on 10/04/2023 02:07 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:YOUNG FAMILY CHILD CAREFACILITY NUMBER:
367700205
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Johnetta YoungTIME COMPLETED:
02:20 PM
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On 10.4.23, Licensing Program Analyst (LPA) Kris Diaz met with the Licensee, Johnetta Young for an unannounced case management – other for capacity change (increase). The licensee granted access to the home and guided LPA on a tour. People who reside in the home are the licensee, her spouse, and her adult daughter who have fingerprint clearance and TB test and two minor children (17, 7). All adults in the home have the required immunizations against pertussis (TDAP), measles (MMR) and have a signed statement declining the flu vaccine. At the time of the visit Licensee had no children in care. Per the licensee, the small family childcare home operates Monday through Friday 23 hours per day and weekends as needed. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have childcare children who need IMS currently.

This is a one story 4-bedroom, 2-bathroom home with kitchen, living room, formal living room, dining room, laundry room, and garage. Children have access to the living room, formal living room, dining room, bathroom in the hallway to the right after entering the home, and the backyard. The living room has a fireplace that is made inaccessible with a safety latch. Per Licensee, the fireplace is not used. LPA observed age-appropriate toys, books, play structures, and activities in the childcare area and backyard. Off-limit areas include the bedrooms, kitchen, and garage. The hallway leading to the bedrooms has a safety gate to make the area inaccessible and the entry to kitchen has a safety gate on each side to make the area inaccessible. The backyard has a trampoline. Per licensee, parents sign a declaration that states the children are not allowed to use the trampoline. LPA informed licensee that should she decide to use the trampoline the children must use it one at a time and be supervised 100% of the time and when it is not in use the trampoline must be locked and made inaccessible by removing any ladder or accessory that would make it accessible.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds (kept in kitchen cabinet under sink-
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2023
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: YOUNG FAMILY CHILD CARE
FACILITY NUMBER: 367700205
VISIT DATE: 10/04/2023
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and in the hallway in a closet made inaccessible with safety knob), medicines, and hazardous items that can pose a danger to children. The following was discussed with the Licensee:

No deficiencies. Ready for large childcare capacity increase.

Exit interview conducted and report was reviewed with the licensee, Johnetta Young. A copy of this report was read and provided to Licensee on this date.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
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