197700650-4-18-2024-12-CC-JDMO-D4FQZR-20240418123710

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700650
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:37:25 PM

Document Has Been Signed on 04/18/2024 12:37 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:	THORN FAMILY CHILD CARE		FACILITY NUMBER:	197700650
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	04/18/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:10 AM
MET WITH:	Krystal Thorn		TIME VISIT/ INSPECTION COMPLETED:	12:35 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 April 18, 2024, at 9:10 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo, conducted a Case Management inspection with Licensee, Krystal Thorn. The purpose of the case management inspection was to assess the home for a capacity increase and ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The licensee is requesting to provide care for a Large family childcare home (FCCH) for the capacity of 14 children. Fire clearance was granted on April 5, 2024. During the inspection, four children were present in the facility. The Licensee and her sister are providing supervision at the time of the inspection. Per licensee, currently residing in the home is the licensee and two minor children (13 years old twins). The home is described as follows: This is a two-story home with 3 bedrooms, 2 and half bathrooms, kitchen, dining area, living room, family room, loft, attached garage, and backyard (outdoor play area). Per licensee, the living room and dining area will be the main care areas. The family room, downstairs bathroom (bathroom 2) and backyard (outdoor play area) will also be utilized for child care activities. The off-limits of the home are 3 upstairs bedrooms, kitchen, upstairs bathroom (1 and 3), loft, and attached garage. The home has central heating and air conditioning. Indoor: (On limits) Living room and dining room (Main care area): LPA also observed age-appropriate toys, kitchen set toy, cash register machine toy, tables, chairs, blocks, puzzles, books, cubbies, and other toys for children. The pull-down fire alarm is located next to the entrance door. Family room: There is a fireplace located in family room and is covered with a glass door. A metal bar is fastened to the fireplace door frames to prevent access by children. LPA observed one playpen. Bathroom 2: The bathroom was equipped with a toilet and sink and are in operable conditions. LPA observed toilet paper, trash bin with cover, step stool, and liquid hand soap. The bathroom was clean and

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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: THORN FAMILY CHILD CARE	FACILITY NUMBER: 197700650
	VISIT DATE: 04/18/2024

NARRATIVE

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orderly. LPA did not observed razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care.

Backyard (Outdoor Play Area): The facility has no body of water on the premises. The play area is made of concrete and grass and has a patio. LPA did not observe cutting and gardening tools at the outdoor play area. Per licensee, there is a gardener that maintains the cutting of grass. LPA observed a caterpillar tunnel, seesaw, small plastic benches, basketball hoop, toy house with slide, small slide, and tricycles. Licensee showed LPA the exit door for the outdoor play area. LPA observed a cable that is attached to the door lock which can be open by pulling the cable. Per licensee, the Fire Department recommend attaching a cable to the exit door in case of emergencies. Licensee added that she put a safety lock after day care hours.
Napping equipment: LPA observed thirteen sleeping cots; ten sleeping cots are stored in the hallway cabinet and three are in the garage.

Off Limit areas:
LPA observes a child safety wooden baby gate barricading the entrance upstairs.
Kitchen: All sharp utensils and knives are stored in a plastic container in the upper cabinet of the kitchen. The refrigerator, stove and microwave are clean. The kitchen is free of hazardous items. The Licensee prepares meals and snacks for the children in care.
Bedroom 1: (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a full-size bed, dresser, television, and personal belongings.
Bedroom 2: (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a full-size bed, dresser, television, and personal belongings.
Bathroom 1: Located upstairs. Per licensee, the bathroom was furnished with toilet and sink which can be access by bedroom 1 and 2. Licensee added that the toilet and sink are in operable conditions.
Bedroom 3 (Master Bedroom and Bathroom) (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a queen-size bed, dresser, mirror, lamp, television, and personal belongings. The bedroom is also equipped with a personal bathroom (bathroom 3) with toilet, tub, shower, and sink and are in operable conditions.
Garage (Off limits): Located adjacent to the living room. LPA observed the garage serves as a storage area for day care supplies and other household items. LPA also observed cleaning compounds are stored in a plastic container in the garage.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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: THORN FAMILY CHILD CARE	FACILITY NUMBER: 197700650
	VISIT DATE: 04/18/2024

NARRATIVE

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Electrical outlets: All electrical outlets are covered with a safety plug cover and made inaccessible to children.
Weapons or Firearms: Per Licensee, there are no firearms in the home.
Cleaning compounds and detergents: Per licensee, they are stored in a plastic container in the garage.
The smoke detector and carbon monoxide detector: located in the living room and in the hallway bathroom and are in operable condition (checked at 10:32 A.M.) The home has a pull-down fire alarm system located above the cubbies by the entrance door of the facility.
Fire extinguisher (2-A:10-B:C) There is a fully charged fire extinguisher (2-A:10-B:C) which meets fire marshal standards. The last service date is on January 5, 2024.
First Aid Kit: Stored inside the hallway cabinet next to the downstairs bathroom.
Medications: Per licensee, she does not have household medications. Licensee also told LPA that zero medications are currently being provided for the current children in care. The assistant was advised to take the in-person CPR/First Aid training either through the American Red Cross, American Heart Association, or any Emergency Medical Services Authority (EMSA) approved/accredited training centers. LPA reviewed the Licensee and assistant files. All required forms were within the files at the time of this inspection. Per LPAs review, the Licensee and assistant have a current mandated reporter trainings completed on December 27, 2022, and January 29, 2024; CPR/First Aid trainings were completed last September 13, 2022, and January 29, 2024. Licensee and assistant have proof of immunization against measles, pertussis, and influenza. Licensee and assistant have TB skin test on file.

Licensee and other adults working in the home have received criminal record clearance. Based on the Guardian employee roster, the licensee is the only person that is associated in the facility. Licensee provided a copy of the letter from the Department stating that the assistant if fingerprint cleared. LPA told the licensee that licensee will associate her assistant on the Guardian employee roster.

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her 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

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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

FACILITY NAME: THORN FAMILY CHILD CARE	FACILITY NUMBER: 197700650
	VISIT DATE: 04/18/2024

NARRATIVE

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Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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

LPA and Licensee discussed the large family home capacity regulations. LPA also discussed the personal requirements for the new staff person.

There were no deficiencies cited today. As a result of this inspection, the home does meet Title 22 Regulations. Capacity increase is pending final approval from the Licensing Program Manager.

Exit interview conducted, a copy of this report, Notice of Site Visit, and appeal rights were provided with the licensee, Krystal Thorn.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC809 (FAS) - (06/04)

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