<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419399
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:41:57 PM

Document Has Been Signed on 03/20/2024 03:41 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MC CAREY FAMILY CHILD CAREFACILITY NUMBER:
197419399
ADMINISTRATOR:MC CAREY, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 252-5089
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:37 PM
MET WITH:Andrea McCareyTIME COMPLETED:
04:00 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 3/20/2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 3-Year inspection at the McCarey Family Child Care. Upon arrival, the LPA met with the licensee, Andrea McCarey, who guided the LPA on a facility tour. Individuals that reside in the home include 3 adults (licensee, licensee’s husband, and licensee’s daughter) and 1 grandchild. When LPA arrived to the facility, the licensee was not home. 11 childcare children and 2 assistant were present. The licensee arrived few mininute after. Per the licensee, the hours of operation are Monday to Sunday for less than 24 hours. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS.
The home is set up as follows:
This is a two-story, 5-bedroom, 3-bathroom home with a kitchen, living room, formal dining room, laundry room, family room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows have screens free of cracks, bugs, and debris.
Main Area: Main care is provided in the living room. Children use the bathroom in the hallway on the left. Children have access to the living room, kitchen and backyard.
Off-limit areas include all bedrooms, bathrooms #2 and #3, entire upstairs, laundry room (upstairs), and garage (has a key lock door knob).
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 11
Document Has Been Signed on 03/20/2024 03:41 PM - It Cannot Be Edited


Created By: Carol Heath On 03/20/2024 at 03:14 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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

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, LPA observed 2 assistants do not complete the Mandated Reporter Training,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/29/2024
Plan of Correction
1
2
3
4
The licensee will ask the assistants to complete the Mandated Reporter Training and email LPA the certification.
Section Cited
Personnel Requirements
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2024


LIC809 (FAS) - (06/04)
Page: 2 of 11
Document Has Been Signed on 03/20/2024 03:41 PM - It Cannot Be Edited


Created By: Carol Heath On 03/20/2024 at 03:14 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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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, LPA observed both assistants do not have shot record for MMR and Dtap, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/05/2024
Plan of Correction
1
2
3
4
The licensee will email the IZ record to the LPA by 4/5/2024
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

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. LPA observed 2 infants did not have LIC 9227 in their file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/29/2024
Plan of Correction
1
2
3
4
The licensee will ask parent to fill out LIC 9227 and email LPA.
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:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2024


LIC809 (FAS) - (06/04)
Page: 3 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
Living room: LPA observed age-appropriate toys and furniture for the children in the designated childcare areas. Several plastic storage bins were observed in which games and toys are stored for the children. There are games and books on the premises of this facility. There are mats on the floor with educational/learning activities. The mats were observed to be in good condition. A TV was observed in the childcare area.
Children's bathroom (#1): The Children will use the bathroom down the hallway to the right. The bathroom was toured and inspected, and the sink/toilet is in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are inaccessible to children with child safety latches on the sink cabinet. The shower/tub is free of hazards (childcare bathroom). LPA did not observe any hazardous items in the children's bathroom. The toilet and faucet are clean and operable. Cleaning supplies are safely latched under the bathroom sink.
Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). LPA observed Sharp utensils, poisons in the kitchen. The child safety latches are not working on cabinet doors and drawers. LPA asked the licensee to remove the knifes until the licensee fix the safety latches. Cleaning supplies are under the kitchen sink. LPA reminded the licensee to make sure the cabinet is inaccessible to the children.
Backyard: The backyard was inspected; The children use the outside backyard for outside play. It is completely fenced (with block cement). A barricaded fence on the side of the home prevents access. LPA observed age-appropriate toys, play equipment, and turf for outdoor play.
Others:
Air Condition Unit was observed. Two outdoor air conditioners with barricaded gates are inaccessible to children. The wood fences are broken and need to repair.
Bodies of water: Per the licensee, there are no bodies of water in the home.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 6 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green, located in the kitchen, and inaccessible to children. It meets standards established by the State Fire Marshall.
Fireplace: In the family room, a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children.
Hanging window blind cords: The cords are inaccessible to children.
Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children and stay in Family room
Medications and cleaning solutions: Detergents and cleaning compounds are in the upper kitchen cabinet, and medications are in the off-limits bedroom.
Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 10 mats in the closet.
Overnight Care: According to the licensee, it does not provide overnight care at this time.
Pets: No pet
Phone service: There is a working cell phone
Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
Stairs (For two-story hours): A safety gate is barricaded to make the stairs inaccessible to the children. When LPA arrived to the facility, the safety gate was no on the stairs. The LPA remined the licensee to put the safety gate during the operation hours.
The first aid kit is in the key-locked closet and is inaccessible to children. The First Aid Kit was observed to be complete with supplies and a first aid manual.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 7 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license, valid vehicle insurance, and vehicle registration.
Weapons or Firearms: Per the licensee, there are No Firearms at the facility at this time. LPA does not observe any firearms.
Documentation:
Child files: LPA reviewed 8 children's records. The records are incomplete and missing forms, but LPA observed that 8 children's files contained all required licensing documents.
Infant Sleeping Plan (LIC 9227) and Sleeping Log: LPA shared the information with the licensee. Per the licensee, NO infant (0-12 months) is enrolled in the facility.
Staff Personnel File: During an annual inspection on 10/13/23 at 12:33 p.m., LPA observed 1 staff information. LPA observed LIC 508, 9052, IZ, TB test, LIC 9108, Mandated Reporter Training, and CPR/First Aid certificates. The file contained all required licensing documents.
Immunization: The licensee and her assistant have the required immunizations (MMR and DTaP). The licensee and her assistant provided a written statement declining the influenza vaccination.
Criminal Record: Per Guardian, all adults who live in this facility obtain a criminal record clearance.
CPR/First Aid: LPA observed that the licensee has current Pediatric CPR and First Aid Training with an expiration date (of 03/2023) 1 hour of nutrition training and (8) hours of Preventive Health and Safety Training.
Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com on 3/2023.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 8 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
Facility fees: Per the Licensing Information System, annual facility fees were current.
Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 03/13/2024.
LPA observed that the licensee (does not) have posted the facility license, emergency disaster plan, earthquake preparedness, and parents' rights poster as required.
The following information was discussed with the licensee:
o A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
o Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children's and provider's files and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.
o The 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
o Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. The licensee was made aware that it is their responsibility to know the regulations, as well as that of anyone who assists in providing care. The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 9 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
o Mandatory Forms for the children's files and provider's files.
o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: [email protected]
o Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
o Requirements for fire drills, earthquake drills, and documentation for both.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
o The licensee is reminded that 100% supervision is required for children at all times.
o The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family childcare home where children are present (24/7 ban).
· Family Child Care Homes Licensee [or facility representative] 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 10 of 11
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: MC CAREY FAMILY CHILD CARE
FACILITY NUMBER: 197419399
VISIT DATE: 03/20/2024
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
26
27
28
29
30
31
32
· IF THERE IS NO CHILD AT THE FACILITY THAT CURRENTLY NEEDS IMS, USE AS FOLLOWS: 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/.
· Centers and Family Child Care Homes Licensee [or 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.
· 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.
· Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

An exit interview was conducted, and the report was reviewed with the licensee, Andrea McCarey.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
Page: 11 of 11