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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700077
Report Date: 10/11/2021
Date Signed: 10/11/2021 01:38:40 PM

Document Has Been Signed on 10/11/2021 01:38 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:YARBER FAMILY CHILD CAREFACILITY NUMBER:
367700077
ADMINISTRATOR:YARBER, HEATHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 519-1444
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
10/11/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Heather YarberTIME COMPLETED:
01:53 PM
NARRATIVE
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Licensing Program Analyst's (LPAs) Thompson-Miller and Ibitoye met with Licensee, Heather Yarber, for a Case Management - Incident Inspection. The incident occurred on September 8, 2021. There are three children present along with Licensee.

Description of the incident: Child wandered away
Licensee self reported a child wandered away from the facility and was found by neighbor. Licensee was taking a broken playhouse out to the street for trash. Upon returning to the backyard, she assisted the children in cleaning and putting away the toys, transitioned inside the home to wash hands and noticed a child missing. Immediately she called out child name and searched inside and outside of the home. During the search in the backyard she noticed the side (left) gate was open and ran to the front of the home where she observed child with the neighbor. Neighbor informed licensee that the Police was notified.

Based on information provided and interviews conducted the incident does appear to have been the result of a violation of the Title 22 regulation, therefore deficiency is being cited. Facility is being issued LIC809D deficiency and LIC9224 Acknowledgement of Receipt of Licensing Report. Exit interview conducted and a copy of this report was read and provided to Licensee Heather Yarber on this date.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Linda Thompson-Miller
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2021
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 10/11/2021 01:38 PM - It Cannot Be Edited


Created By: Linda Thompson-Miller On 10/11/2021 at 12:52 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: YARBER FAMILY CHILD CARE
FACILITY NUMBER: 367700077

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/12/2021
Section Cited
CCR
102417(g)(6)

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102417 (g)(6) Outdoor play areas shall be either fenced, or outdoor play shall be supervised by the licensee or caregiver. This requirement was not met as evidenced by: Licensee was moving a broken playhouse to the front yard as children were in the backyard playing.
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Licensee shall supervise children and will not leave children without any staff supervision. Licensee shall provide a written statement of how supervision of children will be conducted by due date.

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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:Linda Thompson-Miller
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2021


LIC809 (FAS) - (06/04)
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YARBER FAMILY CHILD CARE
FACILITY NUMBER: 367700077
VISIT DATE: 10/11/2021
NARRATIVE
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Upon receipt of the Type A Violation(s), licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Linda Thompson-Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021
LIC809 (FAS) - (06/04)
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