197700349-3-28-2024-12-CC-JDMO-D3T2FD-20240328172123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700349
Report Date: 03/28/2024
Date Signed: 03/28/2024 05:21:40 PM

Document Has Been Signed on 03/28/2024 05:21 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	THOMPSON FAMILY CHILD CARE		FACILITY NUMBER:	197700349
ADMINISTRATOR:	THOMPSON, KENDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 471-9236
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	03/28/2024
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	03:47 PM
MET WITH:	Kendra Thompson		TIME COMPLETED:	05:20 PM

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On March 28, 2024, at 03:20 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with Licensee Kendra Thompson for the purpose of conducting the annual continuation inspection. Upon arrival, LPA observed three children and one infant in care.

Physical Plant: During yesterday’s inspection, March 27, 2024, 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. The smoke detector and carbon monoxide detector are in operable condition (tested at 3:00 P.M.). The fire extinguisher is fully charged with a 2-A:10-B:C classification (reading in green) and the service date was February 27, 2023. Licensee stated that she owns no firearms, and no one smoke in the facility. Per licensee, cleaning products and detergents are stored in the laundry room (off limits) and are inaccessible to children. LPA observed knives are stored on top of the refrigerator in the kitchen of the facility. There is metal fence that separates the day care room from the kitchen (off limits). Per licensee, household medications are stored in the licensee’s room. Licensee stated that zero medications are currently being provided for the current children in care. Licensee is a member of a food program and is providing meals and snacks to children.

The facility is a one-story house. There is a fireplace near the kitchen and is covered with a glass. The home has central heating and air conditioning units.

Based on records review, fire/earthquake drills were conducted on February 6, 2024, at 10:00 A.M., and are conducted once a month.

LPA also observed children’s books, television, puzzles, building blocks, playhouse, play pen, table, chairs, and other learning materials in the facility. LPA also observed six sleeping mats for children to use during napping. The first aid kit box is on top of the the cubbies in the day care room. LPA observed electrical

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: THOMPSON FAMILY CHILD CARE	FACILITY NUMBER: 197700349
	VISIT DATE: 03/28/2024

NARRATIVE

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outlets are covered with a safety plug to prevent access by children in care.

Licensee is advised that baby bouncers, saucer chairs, or any recalled and or banned toys or sleep/ play equipment are prohibited on the premises. Licensee is advised to check for fixture, furniture and equipment that have been banned or recalled by the United States Consumer Product Safety Commission.

Currently, the licensee has four children enrolled in the facility including one infant. Licensee stated that when a child shows signs of illness while at the day care, he/she is separated from other children in the corner of the day care room.

At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to [email protected]

Review of records to be maintained: LPA reviewed with licensee 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. LPA reviewed four children’s files, licensee, and assistant’s files. Based on records review, the children’s files are complete. Licensee stated that it was her first time to have an infant enrolled. Licensee was provided with a copy of the LIC 9227 Individual Infant Sleep Plan and was advised to give a copy to the parent. Licensee will send a copy to LPA via email. Licensee and assistant have current mandated reporter trainings dated May 15, 2023; CPR/First Aid trainings were not current and expired last March 19, 2024. Licensee and assistant have proof of immunization against measles and pertussis. Licensee declined the influenza vaccine. Licensee and assistant have TB skin test on file.

Licensee and other adult working at the facility have received criminal record clearance.

The following was discussed with the licensee:

The licensee was reminded that 100% supervision is always required for children in care. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: THOMPSON FAMILY CHILD CARE	FACILITY NUMBER: 197700349
	VISIT DATE: 03/28/2024

NARRATIVE

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care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

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 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.

Licensee 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.

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-and-resources/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.

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 to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Our Quarterly updates come out every 3 months and are also 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]

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: THOMPSON FAMILY CHILD CARE	FACILITY NUMBER: 197700349
	VISIT DATE: 03/28/2024

NARRATIVE

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The Licensee is informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 A.M. to 5:00 P.M.

The facility is not in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo observed a deficiency that may hinder the health and safety of the children in care. Type B deficiency was cited during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

During the exit interview the licensee Kendra Thompson confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit: A Notice of Site Visit (LIC 9213 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.

A copy of this Report was reviewed, and Appeal Rights were also provided to Licensee, Kendra Thompson.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/28/2024 05:21 PM - It Cannot Be Edited

Created By: Joselito DelMundo On 03/28/2024 at 05:05 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: THOMPSON FAMILY CHILD CARE	FACILITY NUMBER: 197700349
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/28/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the facility did not comply with the section cited above by failing to provide the licensee’s CPR/First Aid training which posed a potential Health, Safety or Personal Rights risk to persons in care.
	POC Due Date: 04/12/2024
	Plan of Correction
1 2 3 4	Licensee will email a copy of her CPR/First Aid training certificate to LPA.

Section Cited


	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:

Lady King

LICENSING EVALUATOR NAME:

Joselito DelMundo

LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

LIC809 (FAS) - (06/04)

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