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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700222
Report Date: 09/17/2021
Date Signed: 09/17/2021 12:43:54 PM

Document Has Been Signed on 09/17/2021 12:43 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:HUNTER FAMILY CHILD CAREFACILITY NUMBER:
367700222
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/17/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:53 AM
MET WITH:Keisha HunterTIME COMPLETED:
12:58 PM
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Licensing Program Analysts (LPA's) Justin Dorsey and Babatunde Ibitoye conducted an announced visit with Applicant Keisha Hunter who guided analyst on a tour of the home for a Pre licensing Inspection. This is a two story home with 3 bedrooms, 3 bathrooms, kitchen, dining area, loft and living room. There is a body of water on the premises. Family members residing in the home include 3 adults (Applicant and 2 other adults) and two children. Days/hours of operation will be Monday through Friday from 6:00 AM to 6:00 PM.

Physical Plant: Home is clean and orderly, LPA's observed age appropriate toys and play equipment, working smoke detector and carbon monoxide detector, and fully charged 2A10BC Fire Extinguisher. There is a designated area for ill child(ren) as necessary, no weapon/firearms, facility sketch complete and current, off limit areas includes the homes entire upstairs 3 (bedrooms + 2 bathrooms) and kitchen. There is a working telephone (cell phone + landline), poisons and cleaning items inaccessible to children. During the visit LPA's observed the homes fire place was screened by cardboard in addition to the glass of the fireplace. LPA's advised applicant to add a metal screen for added safety.

Kitchen/bathroom: LPA's observed a child safety gate restricting access to the homes kitchen. The following are inaccessible: Sharp items (in a top cabinet in the kitchen), medications (master bedroom) and chemicals (under the sink) are inaccessible. Toilets and faucets are clean and operable.

Outdoor: LPA's observed the homes backyard. The backyard includes a gated pool. The on limits backyard area includes a turf and concrete area for the children to play. The off limit area of the backyard which is on the side of the house is made inaccessible to children by a chain link gate. LPA's observed the backyard toys and equipment to be in good condition. LPA's did not observe any items that could be hazardous to children in care.

Advisory/Other: First Aid kit readily available. CPR/First Aid expires 02/2023. The electrical outlets are covered. LPA's observed 6 cots for children to nap. Per applicant the children will nap in the living room. Applicant reminded to supervise children at all times.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HUNTER FAMILY CHILD CARE
FACILITY NUMBER: 367700222
VISIT DATE: 09/17/2021
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Pets: Per licensee there are no pets in the home. LPA's did not observe any pets during the pre-licensing inspection.

LPA advised applicant All adults living/residing in the home are fingerprint cleared and associated.

Documents Provided and or Discussed: The following were discussed regarding Title 22 requirements: Safe Sleep and Small Family Child Care Home Ratios

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

The following was discussed with the Licensee/Applicant:Safe Sleep and Small Family Child Care Home Ratios

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; Applicant reminded that 100% supervision is required at all times to children in care; Applicant made aware that it is her/their 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; Regulation prohibits the smoking of any kind during the operation of the day care.

Applicant advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The applicant was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HUNTER FAMILY CHILD CARE
FACILITY NUMBER: 367700222
VISIT DATE: 09/17/2021
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Applicant advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Corrections needed before application can be submitted for approval:


1.) A screen will be added in front of the fire place for additional safety.
2.) Make the AC unit in the backyard inaccessible.
3.) The applicant will make the necessary changes to the pool gate.
  • Ensure the gate is over 5 feet high in all areas.
  • Ensure the pool gate swings away from the pool and is self latching.
  • Ensure that the self latching device is no more than 6 inches from the top of the gate.


Exit interview conducted and a copy of this report was given to Applicant Keisha Hunter.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
LIC809 (FAS) - (06/04)
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