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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700045
Report Date: 02/08/2023
Date Signed: 02/08/2023 02:01:32 PM

Document Has Been Signed on 02/08/2023 02:01 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:HANEY FAMILY CHILD CAREFACILITY NUMBER:
367700045
ADMINISTRATOR:HANEY, CASSANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 910-3573
CITY:TWENTYNINE PALMSSTATE: CAZIP CODE:
92277
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Licensee, Cassandra Haney TIME COMPLETED:
02:10 PM
NARRATIVE
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On February 8, 2023 at 12:15pm Licensing Program Analyst (LPA) Zirbes conducted an unannounced case management inspection to Haney Family Child Care. LPA met with licensee Cassandra Haney. The purpose of the inspection was to discuss the licensee’s Decision and Order (1222172101) which became effective January 31, 2023. Upon arrival, LPA observed the Licensee providing supervision to seven children (three infants and four children under the age of 5). At 12:32pm a parent arrived to the home and picked up C1.
During the inspection, LPA reviewed seven child files. Based on LPAs record review and observation the family child care was out of capacity and ratio when LPA arrived to the home. The Licensee was alone and providing supervision to a total of seven children. Three of the seven children were infants (Child 2, Child 3, Child 4) and four children were over the age of two (Child 1, Child 5, Child 6, Child 7). According to the LPAs record review and Licensees statement zero of the seven children present were enrolled in and attending kindergarten or elementary school and zero children were six years of age. Based on LPAs observation and record review the facility was not meeting the criteria of Health and Safety Code Section 1597.44. Therefore the facility is being cited a type A citation for regulation 102416.5 (b)(3) Staffing Ratio and Capacity. This poses a immediate risk to the children in care. Refer to LIC 809D.
As mentioned during this inspection, LPA reviewed the Decision and Order with the Licensee. Per Decision and Order, Licensee Cassandra Haney is allowed to fully operate a family child care without any restrictions. A copy of the decision and order was provided to the Licensee during this inspection.
In addition, each report (documenting a Type A citation- that pose an immediate Health and Safety risk to children in care) shall remain posted for 30 days along with the Notice of Site Visit, Parents of any currently enrolled children and any newly enrolled children for the following 12 months shall sign form LIC 9224 (Acknowledgment of Receipt of Licensing Reports), a copy shall be kept in each child’s file. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty for each child’s parent who did not sign the LIC 9224 (Acknowledgment of Receipt of Licensing Reports)

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Cassandra Haney.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2023
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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Document Has Been Signed on 02/08/2023 02:01 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 02/08/2023 at 01:22 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: HANEY FAMILY CHILD CARE
FACILITY NUMBER: 367700045

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/09/2023
Section Cited
CCR
102416.5(b)(3)

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102416.5 (b)(3) Staffing Ratio and Capacity: For a Small Family Child Care ...number of children for whom care ...shall be one of the following: More than six and up to eight children, without an additional adult attendant, only if the criteria in Section 1597.44 of the Health and Safety Code are met. This requirement was not met as evidenced by:
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Per Licensee, they will review capacity regulations and either an additional assistant will be present to provide supervision or the capacity regulations will be met. Licensee will watch CCLD capacity videos and send the Department confirmation after the videos have been reviewed.
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 Based on LPAs observation and record review, the Licensee was alone and providing supervision to a total of seven children. Three infants and zero children age 6 and/or enrolled in kindergarten). Therefore the criteria of Health and Safety Code was not met. This poses an immediate risk to the children 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:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023


LIC809 (FAS) - (06/04)
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