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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807995
Report Date: 08/07/2023
Date Signed: 08/07/2023 02:54:31 PM

Document Has Been Signed on 08/07/2023 02:54 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:LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CAREFACILITY NUMBER:
153807995
ADMINISTRATOR:LUKENBILL, KATHRYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 256-2807
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
08/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Kathryn LukenbillTIME COMPLETED:
03:10 PM
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On 8/7/2023, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1 Year inspection at the Lukenbill Family Child Care. Upon arrival, the LPA met with the licensee, Kathryn Lukenbill who guided the LPA on a tour of the facility. Family members residing in the home include 2 adults (licensee, licensee spouse) and two children. All adults living in the home have been background cleared.
This is a large family childcare facility. The hours of operation are Monday through Friday, 5:00 a.m. to 5:00 p.m. During the inspection, LPA observed 11 childcare children (6 school-age, 5 preschools) with Licensee and her assistant. Per Licensing Information System, annual facility fees were current. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The Home is set up as follows:
This is a two-story, 4-bedroom, 3-bathroom home with kitchen/dining, family room, living room, formal dining room, laundry room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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Main Area: Main care is provided in the living room (at the entrance) and family room. Children use the bathroom (Bathroom #1) on the left at the entrance.
Living room/Family room: In the living room, which is the designated playroom, LPA observed age-appropriate toys and furniture for the children. LPA observed: There is a TV that plays educational videos for the children. In the family room, a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children. There were additional toys observed to be in the family room stored in cubbies. A small table was observed with a total of eight chairs. 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 that have educational/learning activities on them. The mats were observed to be in good condition.
Children's Bathroom (#1): Children use the bathroom (Bathroom #1) on the left at the entrance. The Bathroom was toured and inspected sink/toilet is in operable condition. The toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on cabinet doors and drawers. Sharp knives are kept in a butcher block in the gated kitchen.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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Backyard: The backyard was inspected; The backyard is gated all around. Children play in the backyard. There is 2 small dog (the dogs run on the right). There is a large tree and a wooden jungle gym (slide/swing) that is anchored. There is no body of water on the premises.
Off-limit: the areas include The Licensee states the off-limit areas include the entire upstairs (Bedroom #2, #3 and #4, bathroom #2 and #3), Bedroom #1 (key lock), laundry (gated), and garage (key lock).
Others:
· AC/Heating Unit was observed. The AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the unit.
· Bodies of water: Per the licensee, there are no bodies of water in the home. There is a decorative water fountain that has no water.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 2023 and located in the kitchen inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: The fireplace was observed in the off-limits living room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are inaccessible to children.
· Incidental Medical Services (IMS): The Licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, he/she will be separated from other children and stay in the Family Room.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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· Medications and cleaning solutions: Detergents/cleaning compounds are in the off-limit garage. Medications are in the upper kitchen cabinets.
· Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 12 mats and 3 playpen equipment.
· Overnight Care: Pre-licensee does not provide overnight care.
· Pets: 2 small dogs. They have current vaccinations.
· Phone service: There is a working landline or cell phone.
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· Stairs (For a two-story home): There is a safety gate barricaded to make the stairs inaccessible to the children.
· The First Aid kit: The First Aid kit is located in the off-limit area inaccessible to children on top of the refrigerator. The First Aid Kit was observed to be complete with supplies and a first aid manual.
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license. The licensee has valid vehicle insurance and vehicle registration.
· Weapons or Firearms: Per Licensee, there are weapons or firearms on the premise inaccessible to children (separate container with locks). LPA observed that the ammunition stored and locked separately from firearms, and the firing pins shall be stored and locked separately from firearms.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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Documentation:
Ø Child files: LPA observed 5 children's files contained all required licensing documents.
Ø CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (05/2025) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
Ø Criminal Record: Pre Guardian, all adults who live in this facility obtain a criminal record clearance.
Ø Facility fees: Per Licensing Information System, facility annual fees were current.
Ø Facility Roster: LPA observed the facility roster is complete and maintained current.
Ø 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 07/1/2023.
Ø 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.
Ø Licensee has posted as required.
Ø Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com on 7/8/2023
Ø Staff Personnel File: LPA observed 1 staff information. The file contained all required licensing documents.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
NARRATIVE
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The following information was discussed with the licensee:
v Mandatory Forms for the children's files and provider's files.
v The licensee is reminded that 100% supervision is required for children at all times.
v Capacity requirements, Roster requirements, and Documentation requirements for disaster drills (fire and earthquake).
v Licensee was made aware that it is their responsibility to know the regulations and anyone who assists in providing care. 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.
v Licensee was advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
v 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).
v Criminal Record Statement: The licensee [or facility representative] 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 support or exemption prior to the 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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v Safe Sleep: LPA discussed the safe sleep regulations with the licensee [or facility representative] 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 the licensee [facility representative] 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.
v 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.
v Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
v Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
v 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).
v Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
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: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 08/07/2023
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v The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.

No deficiency was cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

An exit Interview was conducted, and a copy of this Report and a Notice of Site visit were provided to the licensee, Kathryn Lukenbill.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
LIC809 (FAS) - (06/04)
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