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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844209
Report Date: 09/14/2023
Date Signed: 09/14/2023 01:57:20 PM

Document Has Been Signed on 09/14/2023 01:57 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:DANTZLER FAMILY CHILD CAREFACILITY NUMBER:
364844209
ADMINISTRATOR:DANTZLER, LORETHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 553-2777
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
09/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Loretha Dantzler, LicenseeTIME COMPLETED:
02:15 PM
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On September 14, 2023, Licensing Program Analyst (LPA) Calloway met with Licensee, who granted access. LPA and Licensee toured the home for an Annual Random inspection. Family members residing in the home include 3 adults (licensee), spouse, and mother. All adults living in the home are criminally background cleared. The home is licensed for fourteen (14) children. There are three (3) assistants. LPA observed eight (8) preschool children in active lesson and three (3) infants in care and four (4) staff.
Physical Plant: This is a two story 4-bedroom, 3- bathroom home with kitchen, dining, family room, living room, and garage. Childcare is provided in Livingroom (upon entry) and Family/dining room (next to the kitchen). Children Bathroom is in hallway (left) next to the kitchen. Age-appropriate toys and books. Napping (mats, cribs) equipment. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (upstairs), medicines (off limits bedroom). Kitchen hazardous items (sharp knives top of refrigerator) that can pose a danger to children. Fire/earthquake drills (current). Roster (current). The required fire extinguisher (2A10BC) is full/green. Smoke detectors and carbon monoxide detectors (operable). Fireplace (permanently covered). Home has central AC and heat. Required postings were present on the wall. Unused outlets (covered). Three cabinets inside the day care area have supplies and do not pose a danger to the children. Stairs (gated).
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209
VISIT DATE: 09/14/2023
NARRATIVE
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 LPA observed two (2) baby walkers that were immediately removed from the day care area. One infant (8 months) sleeping on their side. LIC 9227 (current). Landline phone and cell phone. Cameras observed in day care area.
Off limit areas: include Bedrooms (#1, #2, #3, #4), Bathroom #2, Bathroom #3, garage (key lock), kitchen (gated). Outside area on the left (locked gate).Outside: The backyard is completely fenced. No pets observed. Swing set anchored, age-appropriate toys. No pool/spa or body of water on the premises. Artificial grass and concrete for play, shaded area (observed). Shed (safety latch). AC unit (covered).
Other: Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any in the home. Required training and CPR/First Aid (current). The First Aid kit (observed). LPA viewed staff and children’s file (missing information) and conducted a staff interview with the licensee. Transportation is provided (insurance verified).
The following was discussed with the Licensee:
Capacity requirements, Notification of Parent's Rights, Roster requirements (keep updated names), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, updated. Safe Sleep regulations were discussed and provided. The role and responsibilities of being a mandated reporter. Licensee reminded that 100% supervision is always required to all children in care. If food is brought in, it is properly labeled. Licensee will check food expiration dates periodically.Licensee was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee advised that 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
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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: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209
VISIT DATE: 09/14/2023
NARRATIVE
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 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). Type A citation: Type A citation(s) shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of the report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Failure to do so will result in a Civil Penalty being assessed. State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee is advised visit www.shotsforschool.org for Immunization information.

--Licensee was informed of responsibility to report suspected Child Abuse, 1-800-827-8724/760-243-6640


--Family Child Care Providers (Disaster Planning information): https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Child Care Videos: https://ccld.childcarevideos.org
--Licensee advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
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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: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209
VISIT DATE: 09/14/2023
NARRATIVE
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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.

The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm for information and reporting Unusual Incident Reports. LPA provided consultation (Safe Sleep) during the inspection.

There are deficiencies cited during the inspection. See 809 D pages.

An exit interview was conducted, a copy of this report was read, and a Notice of Site Visit were provided to Loretha Dantzler, Licensee at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/14/2023 01:57 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 09/14/2023 at 01:32 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: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2023

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, record review, the licensee did not comply with the section cited above in one out of four staff (S2) did not have Mandated Reporter traning current which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/21/2023
Plan of Correction
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Licensee will provide proof of training to Licensing by the POC date of 9/21/23.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, record review, the licensee did not comply with the section cited above in two out of four staff (S2 and S3) did not have current TB test in staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/28/2023
Plan of Correction
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Licensee will provide proof to Licensing of TB test by POC date of 9/28/23.
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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/14/2023 01:57 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 09/14/2023 at 01:32 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: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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, record review, the licensee did not comply with the section cited above in one out of four staff (S2 and S4) did not have proof of MMR, TDAP, in staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/28/2023
Plan of Correction
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Licensee will provide proof of immunizations to Licensing by POC date of 9/28/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/14/2023 01:57 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 09/14/2023 at 01:32 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: DANTZLER FAMILY CHILD CARE
FACILITY NUMBER: 364844209

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, record review, the licensee did not comply with the section cited above in one out of eight children (C6) did not have a signed LIC 995A form in their files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/18/2023
Plan of Correction
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Licensee will provide proof of signed form from Parent by POC date 9/18/23.

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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023


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