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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019270
Report Date: 09/12/2024
Date Signed: 09/12/2024 01:31:13 PM

Document Has Been Signed on 09/12/2024 01:31 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PALMER FAMILY CHILD CAREFACILITY NUMBER:
198019270
ADMINISTRATOR/
DIRECTOR:		KELSIE & VICTORIA PALMERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 427-1437
CITY:PARAMOUNTSTATE: CAZIP CODE:
90723
CAPACITY: 14TOTAL ENROLLED CHILDREN: 17CENSUS: 6DATE:
09/12/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Victoria Palmer, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced Random Annual Inspection on this date. LPA met with Victoria Palmer, who provided tour of facility. LPA explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the current hours of care provided are Monday – Friday 6:00am - 1:00am. The licensee is currently operating overnight care as needed, LPA discussed with licensee that "Overnight Care" means care being provided to children anytime between the hours of 6 p.m. and 6 a.m. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered care. There were 6 children present, including 2 infants. Also present was Adult #1, who resides in home but does not assist with daycare. Kelcie Palmer, Assistant arrived at 10:00am with 1 additional child. All adults present and residing in the home were discussed, noted and have been cleared and associated.

This is a two-story home which consists of 6 bedrooms, 4 bathrooms, kitchen, dining room, living room, den, front yard and backyard (fenced). LPA observed that there is a fireplace between the den and dining room areas and it is screened.

Per licensee, the areas used by children include: The den (main childcare area), Bedroom 1/nursery (located to the left upon entry to hallway), bedroom 2 (Hallway next to Bedroom 1), bathroom (Hallway next to Bedroom 2), kitchen and the backyard.

Off limit areas: 1st Level Bedroom 3 (Hallway next to bathroom), Attached garage (accessible through kitchen). 2nd level: 3 bedrooms and 2 bathrooms. Backyard also has a detached shed.

Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation, and heating.

At 9:20am LPA observed the stairs leading upstairs (located inside daycare area) observed without a gate and partially barricaded by a play yard. This poses potential risk to the safety of children in care. --Page 1 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PALMER FAMILY CHILD CARE
FACILITY NUMBER: 198019270
VISIT DATE: 09/12/2024
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LPA observed Bedroom 3 to be closed/inaccessible during this visit. The licensee was reminded that licensing staff may have access to in off-limit areas during inspection visit if necessary.

LPA observed Publication (PUB) 394- Notification of Parent Rights, License and LIC 610- Facility Disaster Plan posted by entrance to home. Licensee was reminded to post the required posted documentation in a location visible to parent/guardians of children in care. LPA reviewed LIC 9040- Facility Roster,

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 8/29/24. The home maintains telephone service via cell phone.

LPA reminded licensee to maintain home clean and orderly. There are toys and other age-appropriate material available.


LPA observed that cleaning compounds in kitchen were in location where children might access (photo taken) posing a potential risk to children in care. Licensee removed the cleaning items. Safety locks need to be assessed regularly to make sure they are still able to inaccessible to children in care.

Per Licensee there are no poisons, firearms or weapons stored in the home. All poisons must be locked, not only inaccessible to children.


The licensee provided meal to children in care. LPA observed children in care treated with respect during this visit. There are 2 infant enrolled under 12 months. 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.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has age appropriate toys and other materials for children to play with. LPA observed rotting fruit on grass ( from fruit trees), a wheel barrow placed upside down, air conditioning unit not covered, sprinkler with wires sticking out. Items on top of bar area that can fall on children, posing a potential health, safety or personal rights risk to persons in care. There are no bodies of water. LPA observed 1 medium sized dog in the home. Per licensee, the family pet kept in the side yard off limits during daycare hours. ------------------Page 2 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PALMER FAMILY CHILD CARE
FACILITY NUMBER: 198019270
VISIT DATE: 09/12/2024
NARRATIVE
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Licensee, staff and children’s records were reviewed for, 1 out 7 children in care was missing immunization records. LPA provided LIC 279 to update adults living in the home.

LPA reminded licensee to pay licensing fees as non payment of fees can result in forfeiture of license,

LPA discussed IMS with Licensee. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/

Licensee 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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Based on the LPA's observations and records review the 4 "B" deficiencies will be cited today in accordance with California Title 22 Regulations.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders (RSO) living in the facility and LPA completed the RSO search in Megan’s Law Website.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensees Victoria and Kelcie Palmer. Appeal Rights were discussed and provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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Document Has Been Signed on 09/12/2024 01:31 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 09/12/2024 at 12:29 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PALMER FAMILY CHILD CARE
FACILITY NUMBER: 198019270

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in due to the outdoor play space had the following: Rotting fruit from tree on the grass, a wheel barrow placed upside down, air conditiing unit not covered, sprinkler with wires sticking out. Clutter on top of bar area should be removed to aviod it falling on children, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/20/2024
Plan of Correction
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Per licensee, the outdoor play area will cleaned, the AC unit covered, wires will be covered, item on top of bar will be removed and photos as proof of correction will be sent to LPA by POC due date.
Type B
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that the barrier (play yard) blocking stairs leading to 2nd floor can easily be moved by children, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/16/2024
Plan of Correction
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Per licensee, a gate will be placed at stairs secured to the railing, a photo of the correction will be sent to LPA by POC due date.
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 09/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/12/2024


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 09/12/2024 01:31 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 09/12/2024 at 12:29 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PALMER FAMILY CHILD CARE
FACILITY NUMBER: 198019270

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that dishwashing pods and lysol aerosol were on counter of kitchen, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/12/2024
Plan of Correction
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The licensee removed the items from the counter and cabinet during visit. Per licensee, cleaning items will be placed in secured cabinets and the locks will be checked regularly to make sure they are still wroking.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

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 in that 1 out of 7 children present did noth have immunization record which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/20/2024
Plan of Correction
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Per Licensee, the records will be obtained and a copy will be sent to LPA by POC due date.
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 09/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/12/2024


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