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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844198
Report Date: 11/18/2022
Date Signed: 11/18/2022 12:59:24 PM

Document Has Been Signed on 11/18/2022 12:59 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:CHILDRESS FAMILY CHILD CAREFACILITY NUMBER:
364844198
ADMINISTRATOR:CORTNEY CHILDRESSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 646-2905
CITY:WRIGHTWOODSTATE: CAZIP CODE:
92397
CAPACITY: 14TOTAL ENROLLED CHILDREN: 26CENSUS: 10DATE:
11/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Licensee Cortney Childress TIME COMPLETED:
01:10 PM
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Licensing Program Analyst (LPA) Zirbes met with Licensee, Cortney Childress who guided analyst on a tour of the facility for the One Year Required inspection. This is two story home with four bedrooms, three bathrooms, kitchen, dining room, living room, laundry room, front/backyard, detached garage, daycare room. Per Licensee the day care room, and bathroom (downstairs) and a portion of the backyard are utilized for child care activities. Per licensee off-limit areas of the home are all four bedrooms, two bathrooms (upstairs), kitchen, dining room, living room, laundry room, detached garage and a portion of the backyard. The off limits areas were inaccessible via key locks on the doors. Upon arrival, LPA observed four preschool age children in care with the Licensee and staff 1 (S1) providing supervision. During the inspection six additional children arrived along with an additional staff member, (staff 2) Currently living in the home are the Licensee, adult 1, and two minor children (5,12). All adults are associated and have eligible clearances. Current days and hours of operation are Monday through Friday 7am to 5pm.

Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. According to Licensee all cleaning products are stored in high inaccessible cabinet located in the kitchen of the day care room and in the locked closet in the day care room. Sharp knives were inaccessible on the top inaccessible shelf in the kitchen of the daycare room. Per recorded documentation Fire/earthquake drills were last completed in October 2022, the fire extinguisher was bought in April 2022.

Safe and age appropriate toys, play equipment and materials were present. The smoke detector and carbon monoxide detector were operable. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. A section of the daycare room is the designated area for ill children in the child care. Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: CHILDRESS FAMILY CHILD CARE
FACILITY NUMBER: 364844198
VISIT DATE: 11/18/2022
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Report continued from page one

Per Licensee, there are zero firearms stored in the home. The home has a fireplace in the off limits area of the home. The fire place is inaccessible via a locked door. The day care room has one window with window blinds. Licensee and LPA discussed best practice in regards to window blinds.

Bathroom: Toilet, sink, faucet, shower were clean and operable. Zero cleaning chemicals or personal hygiene products were stored in the on limits bathroom. A changing table is located in the day care room.

Outdoor: The backyard is divided into off limit and on limit areas. The off limit areas were made inaccessible via a 7ft barrier. At the time of this inspection there were zero bodies of water observed on the premises. The on limit outdoor play area was inspected and play equipment was observed to be free of hazards. LPA observed a dramatic play house, and a tiny tikes climber placed on artificial grass. LPA reminded the Licensee to regularly monitor the play equipment for potential hazards.

Per Licensee, the family has one dog and one cat who are current on shots. Per Licensee, the dog and cat do not interact with the child care children.

CPR/First Aid expires 10/22/2023 and mandated reporter training expires on 02/08/2023.



Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA reviewed ten child files, the Licensees, two staff member files, and one household member file. Based on LPAs record review child, staff and household files were complete and included all required information.

Documents Provided and/or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep.

The following were observed: Notification of Parents' Rights (PUB394), Roster (LIC9040), License, Emergency and Disaster Information (LIC610A).


Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CHILDRESS FAMILY CHILD CARE
FACILITY NUMBER: 364844198
VISIT DATE: 11/18/2022
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Report continued from page two

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified



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). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

Licensee 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 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CHILDRESS FAMILY CHILD CARE
FACILITY NUMBER: 364844198
VISIT DATE: 11/18/2022
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Report continued from page two

LPA and Licensee discussed the unusual incident reports and the reporting requirements.

Based on LPAs record review there were zero citations issued today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Cortney Childress.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4