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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700306
Report Date: 03/18/2025
Date Signed: 03/18/2025 02:20:00 PM

Document Has Been Signed on 03/18/2025 02:20 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:SMITH FAMILY CHILD CAREFACILITY NUMBER:
197700306
ADMINISTRATOR/
DIRECTOR:		SMITH, CARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 208-7582
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
03/18/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Carla Smith, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On March 18, 2025, Licensing Program Analyst (LPA) Annelise Villa conducted an unannounced case management visit to verify licensee remains in substantial compliance with the health & safety standards as required by regulations governing family child care homes. This visit is for the purpose of monitoring the licensee as required by the established Informal Conference in effect. LPA Villa met with licensee, Carla Smith. Licensee has all appropriate forms posted. First Aid/CPR certificate is not valid and expired on 8/2024. LPA Villa confirmed with Licensee all adults residing/working in the home have criminal record/TB clearances. Children’s records were reviewed and found to be complete. Licensee has conducted emergency/disaster drills with daycare children, last drill was on 2/28/2025. At the time of this inspection, there were 1 children present.

This is a two story 5 bedroom, 3 bathroom home with kitchen, living room, dining room, family room, front and back yards, and garage. Main care is provided in the family room. Children use the bathroom off the hallway on the right. Children have access to the main care areas, kitchen, bathroom #1, and back yard. Off limit areas include all bedrooms, bathrooms #2-3, front yard, and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons. Cleaning supplies, medications and alcohol were inaccessible to children in care. There is a barricade present on the bottom and top staircase; licensee is reminded that barricade(s) must remain in place during daycare hours if there are children under 5 years old in care. Drawers and lower cabinets in kitchen/bathroom are either latched or do not contain any hazardous items. There is an operational smoke alarm and fire extinguisher maintained in the home. The home has electrical outlet covers throughout and maintains a First Aid Kit in the main care area. The fireplace has a glass/screen curtain preventing access and fireplace tools have been removed.

Continued on LIC 809-C
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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: SMITH FAMILY CHILD CARE
FACILITY NUMBER: 197700306
VISIT DATE: 03/18/2025
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There are adequate age appropriate toys, books, games, and napping mats/hygienic diaper changing equipment. There are no firearms present on the premises as stated by licensee. Furthermore, there are no bodies of water. The outdoor play area is a fenced backyard, which is free of hazards and has sufficient toys. Per Licensee, there are no pets in the home. Monday - Sunday, 24 hours.

LPA Villa reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat-related illness, child passenger law, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Shaken Baby Syndrome, and Megan's law. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation.

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



Exit interview conducted, and report was reviewed with the licensee. A notice of site visit was given and must remain posted for 30 days. No citation was given today as a result of this inspection.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/18/2025 02:20 PM - It Cannot Be Edited


Created By: Annelise Villa On 03/18/2025 at 01:36 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: SMITH FAMILY CHILD CARE
FACILITY NUMBER: 197700306

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2025
Section Cited
CCR
102416(c)

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(c) The licensee and other personnel as specified shall complete training on... pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
This requirement is not met as evidenced by:
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Licensee shall retake CPR/First Aid course and send proof of completion no later than 4/18/2025.
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Based on record review, the licensee did not comply with the section cited above. Licensee, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Mariela Ramon
LICENSING EVALUATOR NAME:Annelise Villa
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2025


LIC809 (FAS) - (06/04)
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