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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700282
Report Date: 08/19/2025
Date Signed: 08/19/2025 12:41:59 PM

Document Has Been Signed on 08/19/2025 12:41 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:NESBITT FAMILY CHILD CAREFACILITY NUMBER:
367700282
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 13CENSUS: 6DATE:
08/19/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee Sulani NesbittTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On August 19, 2025, at 09:00a.m., Licensing Program Analyst (LPA) Zirbes met with Licensee Sulani Nesbitt who guided analyst on a tour of the home for the Annual/Random inspection.
Upon arrival, LPA observed six children, (three infants, two preschool age children and one school age child), with the Licensee and Adult 1 (A1) providing supervision. Currently living in the home is the Licensee, adult 1 and three minor child. All adults are associated and have eligible clearances. Current days and hours of operation are Monday thru Friday (6am - 6pm).
Physical Plant: This is a single story house with four bedrooms, two bathrooms, kitchen, living room, dining area, attached garage, front yard and backyard with a in-ground pool Per Licensee the on limit areas are the living room, dining area, kitchen, hallway bathroom and the backyard. The off-limit areas of the home are all the bedrooms, garage, and bathroom located in primary bedroom. The off limit areas of the home were inaccessible via child safety gate. 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. During the inspection, LPA observed cleaning products in the cabinet under the kitchen sink. The cabinet was equipped with a child safety lock, therefore the cleaning products were inaccessible. Household medication are stored in a kitchen cabinet equipped with a child safety lock. Knives and sharp items were stored in on top of the refrigerator which is inaccessible to the children in care. Safe and age appropriate toys, play equipment and materials were present. During the inspection the smoke detector and carbon monoxide detector were tested. An audible sound was heard when the items were tested therefore the smoke detector and carbon monoxide detector were found to be operable at this time. The home has window air conditioning units and central heating. The home does not have a fireplace. LPA did not observe baby bouncers/saucer chairs, or any recalled and or prohibited toys on the premises. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: NESBITT FAMILY CHILD CARE
FACILITY NUMBER: 367700282
VISIT DATE: 08/19/2025
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Report continued from page one
Bathroom (located in the hallway of the home): Toilet, sink, shower/tub were clean and operable. LPA reminded the Licensee to ensure all personal hygiene materials are stored on the top shelf of the shower.
Per Licensee, there are zero firearms/weapons stored in the family child care.
Outdoor: The outdoor activity space is located in the backyard. The outdoor space consists of a covered patio with areas of cement, grass and dirt. There are two locked storage sheds in the outdoor space with household materials. A in-ground pool was present in the backyard. The pool is surrounded by a mesh fence that is mounted into cement. There was one gate that provided access to the in ground pool. The gate was observed to be self closing and self latching with a key lockable device place no lower than 60 inches. LPA observed zero items around the perimeter of the fence that would allow the fence to be climbable. LPA observed a life ring with a minimum exterior diameter of 17 inches hanging in the pool area. Per LPA observation the life ring was labeled as approved by the United States Coast Guard. LPA observed a 12 foot rescue pool with body hook attachment. A pool alarm was in the pool at the time of this inspection. The pool alarm was tested and made an audible noise. The Licensee was able to provide documentation that the pool alarm was compliant with ASTM International Standard F2208. LPA observed the daily inspection of the pool was being completed as required. There were zero hazards at the time of this inspection.
Per Licensee there are zero pets on the property.

LPA reviewed five child files, the Licensees file, one assistant file. Per LPA review, the licensee and the assistants file were complete and contained all required information. Per LPA record review, two of the five child care children in attendance at the time of this inspection did not have a file which contained all required licensing forms. Child 2 and Child 4 files were missing immunization's, LIC 995, LIC 282, LIC 627, LIC 9150 were missing. According to the Licensee, the parent completed and returned the parent handbook, however did not complete and return the licensing forms. Licensee confirmed child 2 and child 4 did not have a file containing the licensing documents during this inspection. A type B citation was issued. Per LPA record review, Child 1, a child under 12 months of age did not have a completed LIC 9227 in the file. Per Licensee, this document was not completed by the parent. A technical violation was issued. Furthermore, per recorded documentation of Child 1, Child 2 and Child 3's safe sleep logs for June and July 2025, the Licensee documented the total time the child was asleep however was not documenting the time of each 15 minute check as required. A technical violation was issued in 6/24/24, therefore a type B citation was issued today. Report continued on page three
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/19/2025 12:41 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 08/19/2025 at 11:29 AM
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: NESBITT FAMILY CHILD CARE
FACILITY NUMBER: 367700282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

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 in three of three infant files (C1, C2 and C3) reviewed indicted the total time of the nap and not the time of each 15 minutes check, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2025
Plan of Correction
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Per Licensee, the time of each 15 minutes safe sleep check will be documented and maintained as required. A copy of the completed safe sleep checks for the next two weeks will be submitted to the Department.
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.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2025


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Document Has Been Signed on 08/19/2025 12:41 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 08/19/2025 at 11:39 AM
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: NESBITT FAMILY CHILD CARE
FACILITY NUMBER: 367700282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(a)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

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 in two of five child care children in attendance (C2 and C4) on this date did not have a child file containing the required licensing forms which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/26/2025
Plan of Correction
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Per Licensee, a complete child file will be obtained for all children. Licensee will ensure a complete file is obtained prior to admission in the family child care. Licensee will send documentation to the LPA documenting all licensing forms have been received.
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.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/19/2025


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: NESBITT FAMILY CHILD CARE
FACILITY NUMBER: 367700282
VISIT DATE: 08/19/2025
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Report continued from page two
Review of records to be maintained: Per recorded documentation two emergency drill were completed in 2025. The fire extinguisher was purchased in March 2025.
The following was discussed with the licensee:

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.



LPA discussed the safe sleep regulations with facility representative 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 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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

During the exit interview, Licensee Sulani Nesbitt confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Report continued on page four
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC809 (FAS) - (06/04)
Page: 8 of 9
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: NESBITT FAMILY CHILD CARE
FACILITY NUMBER: 367700282
VISIT DATE: 08/19/2025
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Report continued from page three

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.

Based on LPAs record review there were two type B citations issued today along with two advisory notices.

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

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC809 (FAS) - (06/04)
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