367700416-5-12-2026-12-CC-CALI-DTZRLV-20260512130745

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700416
Report Date: 05/12/2026
Date Signed: 05/12/2026 01:08:26 PM

Document Has Been Signed on 05/12/2026 01:08 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:	WALKER JACKSON FAMILY CHILD CARE		FACILITY NUMBER:	367700416
ADMINISTRATOR/ DIRECTOR:	YASHIKA WALKER JACKSON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(442) 347-5678
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	05/12/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:50 AM
MET WITH:	YASHIKA WALKER JACKSON, Licensee		TIME VISIT/ INSPECTION COMPLETED:	01:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On May 12, 2026, Licensing Program Analyst (LPA) Crystal Ali conducted an unannounced annual random inspection. The LPA disclosed the purpose of the inspection and was granted entry by the Licensee. The Licensee guided the LPA on a tour of the home. Upon entry to the facility, the LPA observed 7 children (includes 4 infants), licensee and license volunteer assistant providing care and supervision. Licensee states other assistant comes in afternoon to relieve the morning assistant. Afternoon assistance arrived at 11:55am. Licensee reports she has 13 children enrolled. LPA observed the LIC 9040 to not be current. Licensee updated the LIC 9040 during inspection. Present adults in the home are licensee, spouse, one adult child, and one adult child visiting (all have approved background criminal record clearances). This is a large family childcare home. There are no IMS children. The operational childcare hours are Monday through Sunday from 4:00am to 3:00am, 23 hours. Licensee states currently no overnight children enrolled. Staffing Ratio and Capacity: 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: WALKER JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 367700416
	VISIT DATE: 05/12/2026

NARRATIVE

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This is a one–story house with 4 bedrooms, 2.5 bathrooms, a living room, a family room, a dining area, kitchen, a laundry room area, and a garage. Childcare is provided: The family room is for childcare. Children can access the kitchen, living room, and backyard and bathroom #2. Off limit areas are the 4 bedrooms, 2 bathrooms, both sides of backyard, and garage. Licensee states she has one large dog that does not interact with the children and resides in backyard. Licensee states vaccinations are current. Per the Licensee, there is no smoking, no weapons, and no bodies of water on the premises.
Physical Plant: The daycare areas are family room and kitchen, a half bathroom, and backyard. There is cell phone used for daycare business. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. There is a fireplace behind the entertainment system inaccessible to children. There are age-appropriate toys and equipment on the premises. The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, and cleansing pads/solution was observed to be complete and inaccessible to children kept in hallway closet near kitchen. LPA observed are blind cords in the daycare area. LPA observed a safety gate in the hallway at the entrance of the kitchen. LPA observed two bedrooms and one bathroom that are accessible to children. A technical violation was issued.
Napping: Children are provided napping when needed. Licensee provides napping materials that are cleaned weekly. Napping area are the family room. LPA observed 4 play pens and 6 cots in the family room. If children are ill then licensee states she will have them in the living room resting on cot until parents come to pick them up.
Transportation: The Licensee does provide transportation. LPA observed a valid driver license and car insurance. Licensee states she picks up and drops off children to school.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: WALKER JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 367700416
	VISIT DATE: 05/12/2026

NARRATIVE

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Kitchen: The kitchen was inspected and there were no hazardous or dangerous items. All the sharp utensils and knives were stored on top cabinet to the left of the stove. The refrigerator/ freezer are both working. Detergents/cleaning compounds are kept in hallway closet and laundry room with safety knob making it inaccessible to children. Medications are stored in the top cabinet above the microwave. Licensee states there are no children on medication and one children with food allergies at this time. Licensee states she provides breakfast, lunch, snacks, and dinner for the children. Licensee states she is enrolled in the Ventura food program. Per Licensee, the food program representative came in April 2026. Licensee states the visit went good, no concerns.
Fire Extinguisher: LPA observed two fire extinguishers (2A10BC) is reading in green and is located in the laundry room inaccessible to children. Smoke and carbon monoxide detectors were found to be in compliance per Fire Marshall standards. Licensee states fire marshal came last to the home on since licensee daycare relocated (4/2024). Fire and Disaster drills are conducted at least every six-months, last completed 4/14/26 at 10:00am.
Bathroom: The daycare bathroom is located in the hallway first door on the right. It has 1 sink, 1 toilet. Bathroom is clean and in good repair.
Outdoor Space Activity: The outdoor area is the backyard. LPA observed the following t need repair: the bottom of fence where car is, window needs covering for dog area, and screen door needs repair. A technical violation was issued.
Records/Documentation: LPA reviewed with facility representative the LIC 126, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. LPA observed staff records not to be in compliance. Licensee CPR/FA is not with the approved agency (Red Cross, EMSA, and American Heart Association). S3 records were not present.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: WALKER JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 367700416
	VISIT DATE: 05/12/2026

NARRATIVE

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Licensee was unable to provide S3 records. One Type B was issued for missing records in staff records. LPA reviewed and observed children records (3). Children records are not in compliance. LPA observed no sleep logs for C2 & C3. One Type B was issued for missing records in children records. Licensee had all the required posted documents: Facility License (LIC 203A, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).
Criminal Record Clearance - Family Child Care Homes
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.
Safe Sleep - Family Child Care Homes
LPA discussed the safe sleep regulations with licensee 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 licensee 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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: WALKER JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 367700416
	VISIT DATE: 05/12/2026

NARRATIVE

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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/.
MyChildCarePlan.org – Family Child Care Homes
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Megan’s Law - Family Child Care Homes
During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Deficiencies cited: (see LIC809D) Two Type B’s were issued in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Yashika Jackson.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/12/2026 01:08 PM - It Cannot Be Edited

Created By: Crystal Ali On 05/12/2026 at 12:46 PM

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: WALKER JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 367700416
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.1(a)

Personnel Records

(a) Personnel records shall be maintained on each employee and shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above by not having records present for S3 which poses/posed a potential health, safety or personal rights risk to persons in care. The following items needed: Mandated Reporter Certification, LIC 9052, LIC 9108, immunization record, TB test, and CPR & First aid.
	POC Due Date: 05/18/2026
	Plan of Correction
1 2 3 4	Licensee states she will provide the paperwork to LPA by email.

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
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above by not having safe sleep logs for C2 & C3 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/18/2026
	Plan of Correction
1 2 3 4	Licensee states she will provide the paperwork to LPA by email.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Francisco Pedroza
NAME OF LICENSING PROGRAM MANAGER:

	Crystal Ali
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC809 (FAS) - (06/04)

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