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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700063
Report Date: 10/15/2024
Date Signed: 10/15/2024 11:09:57 AM

Document Has Been Signed on 10/15/2024 11:09 AM - 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:MELVIN FAMILY CHILD CAREFACILITY NUMBER:
157700063
ADMINISTRATOR/
DIRECTOR:		CHUNTE MELVINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 754-4394
CITY:CALIFORNIA CITYSTATE: CAZIP CODE:
93505
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:16 AM
MET WITH:Melvin ChunteTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On October 15, 2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced annual/random inspection at Melvin Family Child Care. Upon arrival, LPA Heath was greeted by the licensee, Chunte Melvin, who provided a facility tour. The home is occupied by one adults (the licensee). Four young children were present during the inspection. The licensee stated that the facility operates Monday through Friday, 23 hours. Incidental Medical Services (IMS) were discussed, and the licensee confirmed that no children currently require IMS.
The home is set up as follows: This is a single-story home with a 3-bedroom and 2-bathroom home for the front home (FH) with a kitchen, dining room, living room, and attached garage. A detached structure is a guest house utilized as the children's playroom. There are no bodies of water on the premises. There is no pool/spa or body of water on the premises. The following areas are used for daycare:
Daycare is provided in the back home (BH), in bedroom #2 (directly at the end of the hallway). Children use the bathroom in the hallway (the first room on the left), and they will use the FH Living area for overnight care. Off-limits areas include the Front House (FH) (FH bedrooms #1 through #3, FH Bathrooms #1 and #2, FH kitchens, FH dining rooms, and FH attached garages) and the BH kitchen.
Backhouse (BH) Bedroom #2: In the designated playroom, LPA observed adequate age-appropriate toys, books, games, napping mats, and hygienic diaper-changing equipment. The carpets and other materials were observed to be in good condition.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
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Children's Bathroom (#1): The bathroom was inspected, and the sink and toilet were operable. The toilet and faucets were clean and safe. The medication cabinet was free of medications or personal items, and all poisons and medications were secured under the sink with child safety latches. The bathroom was clear of any hazardous items.
Kitchen (Safety Gate): The kitchen was inspected and found safe. Hazardous items were stored out of children’s reach using child safety latches. Sharp utensils, poisons, and medications were inaccessible to children, and sharp knives were stored in a butcher block. However, the safety gate was not in place during the inspection, which allowed children access to the kitchen.
Backyard: The fully gated backyard was inspected for outdoor play. It was free of hazards, loose objects, and sharp items. There is a grass and concrete area designated for active play.
Additional Information:
AC/Heating Unit & Swamp Cooler: The AC/Heating unit, located on the right side of the home, is inaccessible to children, with barrels placed to block access. The swamp cooler is similarly kept out of reach of children.
Bodies of Water: The licensee confirmed that there are no bodies of water on the premises.
Electrical Outlets: LPA reminded any unused electrical outlets need to be covered and inaccessible to children.
Fire Extinguisher (2A10BC): A 2A10BC-rated fire extinguisher, reading in the green zone, is located in the kitchen and is inaccessible to children. It complies with State Fire Marshal standards.
Fireplace: The fireplace in the family room is secured with mirrored glass doors and is inaccessible to children.
Hanging Window Blind Cords: Cords are kept out of children's reach.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
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Isolation Area (for Illness): If a child exhibits signs of illness, they will be separated from other children and remain in a designated isolation area.
Medications and Cleaning Solutions: Cleaning solutions and detergents are stored in an upper kitchen cabinet, while medications are kept in an off-limits bedroom.
Napping: Children nap in designated areas under adult supervision. 5 mats were observed in the closet for napping.
Overnight Care: The licensee does offer overnight care. However, No overnight care at this time.
Pets: The home has 1 small dog and 1 big dog in the front house backyard and all of which have current vaccinations.
Phone Service: The facility has a working landline or cell phone.
Smoke & Carbon Monoxide Detectors: Both smoke and carbon monoxide detectors were tested and found to be operational.
First Aid Kit: The first aid kit, stored in a key-locked closet, contains all required supplies and a first aid manual.
Transportation: The licensee does provide transportation services. She holds a valid California driver’s license and valid vehicle insurance and registration.
Weapons/Firearms: The licensee confirmed that no firearms are on the premises, and none were observed during the inspection.
Documentation Review:
Child Files: LPA reviewed 5 children's records. While some forms were incomplete, all necessary licensing documents were observed in the files.
Infant Sleeping Plan (LIC 9227) and Sleeping Log: Two infants have LIC 9227 forms. One child had sleeping log. LPA reminded another child will need to have the sleeping log in accordance with the Safe Sleep Regulation.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
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Staff Personnel File: During the inspection, LPA reviewed 1 staff file, which included LIC 508, LIC 9052, LIC 9108. The assistant will need to have Mandated Reporter Training, TB and CPR/First Aid certificates (No EMSA certify).
Immunization Records: The licensee has up-to-date immunizations for MMR and DTaP, and both have submitted written statements declining the influenza vaccine.
Criminal Record: According to the Guardian, all adults living and working in the facility have criminal record clearance.
CPR/First Aid: LPA verified that the licensee holds current Pediatric CPR and First Aid certifications, which expire on 11/2025. The licensee also completed one hour of nutrition training and eight hours of Preventive Health and Safety Training.
Mandated Reporter Training: The licensee completed the online mandated reporter training at www.mandatedreporterca.com, which expires on 11/2025.
Facility Fees: According to the Licensing Information System, the annual facility fees are current.
Fire/Disaster Drill: The licensee conducts fire and disaster drills every six months, with the last drill documented on 10/1/2024. If no drills were observed, it will be noted. Required Postings: LPA observed that the licensee (does/does not) have the Facility License, Emergency Disaster Plan, and Parents' Rights Poster displayed as required.LPA provided Earthquake Preparedness for licensee to post on the parent board.
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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
NARRATIVE
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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. Licensee was made aware that it is their responsibility to know the regulations as well as 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.
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: www.childcareadvocatesprogram@cdss.ca.gov
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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
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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).
ü LPA discussed the safe sleep regulations with 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 licensee [or 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.
ü 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: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063
VISIT DATE: 10/15/2024
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ü 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/.
ü 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.
ü 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.
ü 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: (List of the deficiencies)
An exit interview was conducted, and the report was reviewed with the licensee, Melvin Chunte.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/15/2024 11:09 AM - It Cannot Be Edited


Created By: Carol Heath On 10/15/2024 at 10:37 AM
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: MELVIN FAMILY CHILD CARE
FACILITY NUMBER: 157700063

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2024

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
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Based on interview and record review, the licensee did not comply with the section cited above. LPA reviewed the assistant's file and did not see the Mandated Reporter Training. The licensee stated the assistant felt more comfortable with Spanish. The licensee was trying to find time to help her to complete the training. LPA checked the website, the training is also availbe in Spanish, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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The assistant will complete the training by Friday and the licensee will email the certification to LPA.
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
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Based on interview and record review, the licensee did not comply with the section cited above. During today inspection, the assistant does not have her TB test and MMR shot record in her file and unable to provide the record to LPA, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2024
Plan of Correction
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The assistant has appointment on 10/29/2024 for the TB and MMR. The licensee will email the shot record and TB result to the LPA by 10/31/2024
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: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2024


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