367700249-1-11-2024-12-CC-AALH-CZE263-20240111160629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700249
Report Date: 01/11/2024
Date Signed: 01/11/2024 04:06:46 PM

Document Has Been Signed on 01/11/2024 04:06 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:	KOHLER FAMILY CHILD CARE		FACILITY NUMBER:	367700249
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	01/11/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Licensee Laura		TIME COMPLETED:	04:30 PM

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On 01/11/2024 Licensing Program Analyst (LPA) Andrew Alemoh conducted an unannounced annual inspection as well as a capacity increase. LPA Initiated inspection as Licensee is requesting to increase her capacity from 8 children to 14 children. The LPA disclosed the purpose of the inspection and was granted entry by Licensee who guided the LPA on a tour of the facility. Upon entry to the facility the LPA observed four children in care with the licensee providing care and supervison. Incidental Medical Services (IMS) policy was discussed.

There is no bodies of water on the premises.

Licensee was initially licensed on 01/07/2022 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children effective 10/16/2023. Family Child Care Home operates Monday through Sunday varied 23 hours depending on family's need. The facility provides breakfast, morning snack, lunch, afternoon snack and dinner as needed dinner depending on the time the children arrive.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: KOHLER FAMILY CHILD CARE	FACILITY NUMBER: 367700249
	VISIT DATE: 01/11/2024

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This facility is a two-story home with 5 bedrooms, 3 bathrooms, kitchen, living room, and dining area. LPA observed the stairway barricaded by a safety gate. The off-limits areas are: all upstairs, 5 bedrooms, and two bathrooms. The laundry room and the garage are also off limits and are kept locked during business hours. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the locked food pantry as well as the medicines. Hazardous items (sharp knives are kept in the kitchen in the upper cabinet high enough that they are inaccessible to children.

There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility at this time, nor did the LPA observe any weapons.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the food pantry which is locked during business hours. Breakfast, lunch, snacks and dinner are provided. Licensee stated she currently does have a food program. Naps are provided on playpens, and cots in the living room.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: KOHLER FAMILY CHILD CARE	FACILITY NUMBER: 367700249
	VISIT DATE: 01/11/2024

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The backyard is utilized by the children for outside play and is fenced all around. The outdoor areas are completely fenced in and no bodies of water were observed.
The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. There is a storage shed in the backyard pertaining extra children storage supplies. Age appropriate play structures and materials were observed. Their is security camera in the front and backyard as well as in the home. No hazardous objects were observed in the backyard used by the children. Their are two dogs and 2 cats on the premises, per licensee dogs and cats do not come in contact when children are present.

The facility’s fire extinguisher (2A10BC) met the State Fire Marshal standards and it is in operable condition. The smoke and carbon monoxide were also found to be in operable condition. LPA observe a fireplace to be barricaded and screened. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents.

The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analysis of any person who will be visiting regularly or for longer than #1 week.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: KOHLER FAMILY CHILD CARE	FACILITY NUMBER: 367700249
	VISIT DATE: 01/11/2024

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Safe Sleep regulations (under 24 months) were discussed with Licensee and referred to the CCL web site for additional information and PINS. Provided licensee with an infant sleep plan form LIC 9227.

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

The First Aid kit with a temperature thermometer was observed and complete. The required fire extinguisher (2A10BC) reading in green, smoke and carbon monoxide detectors were found to be in operable condition. Fire and disaster drills are conducted every six-month last drill was conducted in September 2023.

Licensee had all the required posted documents:

The licensee provided proof of immunization against pertussis (TDAP), measles (MMR), and influenza. Licensee’s Mandated Reporter certification is current and CPR/First Aid is current expires 10-17-25. Mandated Reporter expires on 01/05/26

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: KOHLER FAMILY CHILD CARE	FACILITY NUMBER: 367700249
	VISIT DATE: 01/11/2024

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The following were discussed: No smoking, infant walkers, Johnny jumpers, exercise saucers and any other item that falls into that category are permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty

Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time.

Licensee has met Title 22 regulations; Fire clearance was granted 10/16/2023, therefore, a Large Family Child Care Home License capacity of 14 children has been granted effective today 01/11/2024.

An exit interview was conducted, and a copy of this report, appeal and notice of site visit was provided to Licensee on this day. All Licensing reports are recommended to be kept on file for minimum three years.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

LIC809 (FAS) - (06/04)

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