Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818665
Report Date: 03/02/2018
Date Signed: 03/02/2018 03:16:02 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:ENGLISH FAMILY CHILD CAREFACILITY NUMBER:
364818665
ADMINISTRATOR:ENGLISH, ANTHEA & CEDRICFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 956-9659
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 6DATE:
03/02/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:08 PM
MET WITH:Anthea EnglishTIME COMPLETED:
03:23 PM
NARRATIVE
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Licensing Program Analyst (LPA) Neal met with licensee, Anthea English for the purpose of an Annual/Random inspection. This is a two story home with kitchen, living room, formal dining room, laundry room, family room and garage. The garage is used for storage only and no child care activities are conducted there. There is a pool on the premises. Family members residing in the home include 2 adults (licensee and her husband) and 2 foster children. 2 foster children, 2 grandchildren, 2 child care children were present during the inspection. Incidental Medical Services (IMS) were discussed.

Main care is provided in the family room and downstairs bedroom. Children use the bathroom located near the child care room. Licensee states large day care room is currently off limits. Children have access to the backyard. Off limit areas include the home's entire gated upstairs, kitchen (gated), and living room/dining room (gated) and currently the large day care room. Fireplace is screened. 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.

Children play in the backyard. There is a small play structure on the right side yard. There is a gated pool on the premises. There is 1 small dog. Licensee states first aid kit is located in large day care room.

SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2018
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: ENGLISH FAMILY CHILD CARE
FACILITY NUMBER: 364818665
VISIT DATE: 03/02/2018
NARRATIVE
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Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. LPA observed age appropriate toys and napping equipment on the premises. The required fire extinguisher (2A10BC), smoke detector and carbon monoxide detector are in operable condition. Home has central AC and heat. LPA observed the parent board and required documents are posted.

The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov . Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in 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 tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12 month period, PER PERSON.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2018
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: ENGLISH FAMILY CHILD CARE
FACILITY NUMBER: 364818665
VISIT DATE: 03/02/2018
NARRATIVE
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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

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.



Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

2 type B deficiencies were cited during this inspection. See LIC 809D for details. Appeals rights were given to the licensee.
Exit interview was conducted and a copy of report was read and provided to Licensee on this date.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2018
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: ENGLISH FAMILY CHILD CARE
FACILITY NUMBER: 364818665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/02/2018
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children. Licensee does not have a current roster of children. LPA was unable to observe roster of children enrolled at the facility.
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Licensee states she will complete and provide a current roster of the children in the home by the POC due date by email, fax or mail.
Type B
04/02/2018
Section Cited
HSC
1596.866(b)
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Day care center directors and licensees of family day care homes shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart
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Licensee states she will enroll in and complete current Pediatric CPR/1st aid and email, fax or mail certificate.
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Association, or by a training program that has been approved by the Emergency Medical Services Authority pursuant to this section and Section 1797.191 shall be onsite at all times when children are present at the facility, and shall be present with the children are offsite from the facility for facility activities.
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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.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2018
LIC809 (FAS) - (06/04)
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