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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700309
Report Date: 11/08/2023
Date Signed: 11/08/2023 12:40:50 PM

Document Has Been Signed on 11/08/2023 12:40 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:TAYLOR FAMILY CHILD CAREFACILITY NUMBER:
367700309
ADMINISTRATOR:LYNETTRA TAYLORFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 605-3141
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/08/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Lynettra Taylor, Applicant TIME COMPLETED:
01:00 PM
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On 11/08/23, Licensing Program Analyst (LPA), Justeene Tamayo conducted a Pre-licensing Change of Location inspection from the prior license #367700017 located at 13735 Rodeo Drive, Victorville, CA 92395. Upon arrival, LPA met with applicant Lynettra Taylor . The requested capacity is 14. The fire department has granted a fire clearance. Licensee is advised that as a family childcare home operating at full capacity, she must adhere to the following: Operate with a Maximum of 14 children in care with no more than 3 Infants, also must have 2 school age children enrolled. Or Max. 12 Capacity with no more than 4 infants. A Qualified Assistant must be present when more than 8 children are in care. LPA observed 3 preschool children in care.

This is a two story 5-bedroom, 3-bathroom home with kitchen, dining room, living room, family room, laundry room, and garage. There are no bodies of water on the premises. Family members residing in the home include two adults (Licensee and Licensee's daughter) and one minor child. Hours of operation are Monday through Sunday for less than 24 hours. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: The home is clean and orderly. Main care will be provided in the family room area near the front door entrance and living room area. Children will only have access to the family room area, dining room, and living room area. LPA observed the family room area to be fully barricaded by safety gates near the front entrance. Children will use the bathroom across the hall on the left hand side. Children will nap on cots in the main care area. Off limit areas include all bedrooms (barricaded by safety gate), bathrooms #2 and #3 (upstairs), laundry room (key locked), entire upstairs(barricaded by safety gate), backyard(backdoor latched and locked) and garage(key locked). The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (upstairs in laundry room) that can pose a danger to children. Medications will be stored upstairs in off limit area. Sharp knives are located on top of refrigerator unreachable to children in care.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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The smoke detector and carbon monoxide detector are in operable condition. LPA observed the required fire extinguisher (2A10BC) is fully charged. The facility sketch is complete and current, there is working telephone (cell). Fireplace screened in living room. Home has central AC and heat.

Safe and age appropriate toys, play equipment and materials were observed. Electrical outlets are inaccessible. LPA reminded licensee, no baby bouncer saucer chairs, or any recalled and or prohibited toys or sleep/play equipment are allowed on the premises. There is age appropriate napping (mats) equipment. There are no window cords (tied high) accessible to children.

Bathroom: Bathtub and shower are free of hazards. The following are inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish. Toilet and faucet are clean and operable.

Kitchen: The home has a clean and fully stocked clean refrigerator/freezer. Breakfast, lunch, snacks, and dinner will be provided. Food brought from the children’s home shall be labeled and dated. Applicant currently has a food program.

Outdoor: The backyard is off limits to day care children. LPA observed the backyard to be fully barricaded with a wood fence. Per licensee, she has one dog on the premises (vaccinations obtained).

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. Licensee has CPR/First Aid 01/28/2023, CPR/First Aid will expire on 07/09/2025. Licensee's Mandated Reporter Training was completed on 10/06/2023. Mandated Reporter Training will expire on 10/06/2025. Review of records to be maintained: LPA reviewed with applicant 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 PIN 20-24-CCP, Individual Sleeping Plan (LIC9227), Large and Small Child Care Ratio Packet, and Lead Poisoning flyer's. Applicant stated currently has childcare insurance.

The following were observed/discussed and or provided: Seat Belt Safety, Safe Sleep poster observed, forms required for children file (LIC311D), Notification of Parents' Rights (PUB394), Roster (LIC9040), License, Staffing and Ratio (capacity limitations handout provided), Emergency and Disaster Information (LIC610A, LIC9148), Lead Flyer Requirement, liability insurance (LIC282) must have signed form on file if no liability insurance. Names of all adults living in the home: All adults living/residing in the home are fingerprint cleared and associated.

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed - related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

PIN 22-01-CCLD dated 5/23/22

Individuals who hold a criminal record clearance or exemption must notify the Department within ten (10) calendar days of any change to their mailing address to ensure effective communication related to a criminal record clearance or exemption. Providers and Licensees are encouraged to ensure individuals on their employee/staff rosters are aware of this new requirement.

Individuals may update their mailing address with the Department in various ways, including: logging into their Guardian account; sending an email to Guardian@dss.ca.gov; calling the customer service line at 888-422-5669; sending a request to update by fax at (916) 754-4589; or mailing the address change information to:

Care Provider Management Bureau

744 P Street MS T9-15-62

Sacramento, CA 95814

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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The following was discussed with the Applicant:

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter (www.mandatedreporterca.com) were reviewed, to be completed every two years; Applicant reminded that 100% supervision is required at all times to children in care; Applicant made aware that it is his/her/their 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; Regulation prohibits the smoking of any kind during the operation of the day care. Applicant currently does not have Child Care Insurance. Per Applicant no on smokes in the home. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. Applicant advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov.

Applicant advised of the requirement to report Unusual Incidents. Applicant informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Applicant advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to part obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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Prior to making alterations or additions to a family child care home or grounds, the Applicant shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. Applicant shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Applicant 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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Applicant shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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LPA discussed the safe sleep regulations with applicant and also instructed applicant to visit 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 applicant 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.

If you have questions regarding this PIN, please contact CPMB at 888-422-5669 or Guardian@dss.ca.gov for assistance.

The Department will convey all new information through PINs. Please sign up to be notified here and visit the Department’s website for the latest PINs.

Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days. Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

During this inspection, LPA reviewed the conditions set forth in the Proposed Decision and the department’s decision and Order dated 2/23/22 under license #367700017. The license was placed on probation for a period of two years with the following terms and conditions:




SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 367700309
VISIT DATE: 11/08/2023
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The Licensee is placed on probation for two years on the following terms and conditions:
1. Respondent Ms. Taylor shall operate the facility in strict compliance with the regulations and statutes governing the operation of a family childcare home.
2. During the probation period, the department in its sole discretion may conduct unannounced site visits for the purpose of determining whether there is full compliance with the regulations and statutes governing the operation of a child day care facility.
3. Respondent Ms. Taylor shall ensure that all individuals working, residing, or volunteering in the facility shall obtain criminal record clearances or exemptions prior to their initial presence in the facility and shall maintain proof of such criminal record clearances
or exemptions at the facility.
4. Respondent Ms. Taylor shall maintain current personnel records of each employee at the facility and ensure that all employees have a current certificate of CPR and first aid training on file at the facility.
5. The proposed decision and the Department’s Decision and Order shall be posted in a conspicuous place at the facility for the duration of the probationary period.

Respondent Ms. Taylor understands that she must pay a probation monitoring fee equal to the annual fee for the license during the probation period as required by Health and Safety Code section 1596.803. If Respondent Ms. Taylor has successfully complied with the terms of this Proposed Decision and the department’s Decision and Order, at the end of two years from the date of the department’s Decision and Order.

The facility is ready to be licensed and the license will be placed on probation for the remainder probationary period which ends on 02/25/24.

The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm. Exit interview conducted and report was reviewed with applicant. This report was read and provided to applicant on this date, as well as Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
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