197492784-4-4-2023-12-CC-AALH-CQKSSE-20230404140746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492784
Report Date: 04/04/2023
Date Signed: 04/04/2023 02:08:07 PM

Document Has Been Signed on 04/04/2023 02:08 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:	LEE FAMILY CHILD CARE		FACILITY NUMBER:	197492784
ADMINISTRATOR:	LEE, JUNG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 670-8063
CITY:	STEVENSON RANCH	STATE: CA	ZIP CODE:	91381
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	04/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Licensee Jung Lee		TIME COMPLETED:	02:20 PM

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On 04/04/23 Licensing Program Analyst (LPA) Andrew Alemoh, met with licensee, Jung Lee and (licensee spouse) who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story 2 bedroom, 3 bathroom home with kitchen, dining room, family room, office space, and a garage. There is no pool on the premises. Upon arrival LPA observed 4 children in care and licensee caring for them. Family members residing in the home include 2 adults (licensee, licensee's husband and licensee's son). Facility hours of operation are Monday - Friday 8AM- 5 PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the play room. There are cubbies with children's names to store their belongings. Naps are provided on mats in the living room area. The children use the bathroom located in the hallway to the left. The off-limits areas are: all upstairs(barricaded by a baby gate) two bedrooms, and two restrooms. Laundry room and garage are also off limits and are kept locked during business hours. LPA observed a baby gate barricading access to the kitchen from the play room area. There is another baby gate barricading the living room area. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the garage/laundry area, medicines are kept in the closet of the 2nd floor and hazardous items (sharp knives are kept in the kitchen high enough that they are inaccessible to children.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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

FACILITY NAME: LEE FAMILY CHILD CARE	FACILITY NUMBER: 197492784
	VISIT DATE: 04/04/2023

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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, no one smokes in the home, and there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 04/04/2023. The fireplace was observed in the living room area to be fully screened. Facility roster is maintained current. There is a sign in and out sheet at the entrance of the day care home.

Bathroom: Shower/tub are free of hazards. Toilet and faucet are clean and operable. LPA observed the cabinets underneath the kitchen sink to have safety latches.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the garage which is locked during business hours. Lunch, and snacks are provided. Licensee stated she currently does not have a food program.

Outdoor: The front yard is off limits. The backyard is completely fenced in with a brick wall and a black iron fence. There is one dog in the premises. Per licensee, the dog does not come in contact when children are present. LPA observed age appropriate toys, well secured and safe for children. LPA observed the BBQ pit to be fully covered located on the left side of the backyard. The AC unit is barricaded by a baby gate making it inaccessible to children. There are no bodies of water in the premises.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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

FACILITY NAME: LEE FAMILY CHILD CARE	FACILITY NUMBER: 197492784
	VISIT DATE: 04/04/2023

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Advisory/Other: First Aid kit was observed with supplies readily available located in the office space. CPR/First Aid expires 02/03/24. Mandated Reporter has expired. LPA reminded licensee; mandated reporter/CPR training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does have child care insurance. Per licensee she does not provide care for infants.

Licensee Jung 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 Jung and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

LIC809 (FAS) - (06/04)

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