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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700236
Report Date: 02/07/2024
Date Signed: 02/07/2024 04:12:40 PM

Document Has Been Signed on 02/07/2024 04:12 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:YARBER FAMILY CHILD CAREFACILITY NUMBER:
367700236
ADMINISTRATOR:HEATHER YARBERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 519-1444
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
02/07/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Heather Yarber, LicenseeTIME COMPLETED:
04:15 PM
NARRATIVE
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On February 7, 2024, Licensing Program Analysts (LPAs) Calloway and Ali made an unannounced Case Management inspection to the above facility. LPA's met with facility representative who allowed access. Licensee was not home when LPA's arrived, but Licensee and other facility representative arrived later. LPA's toured the home inside and outside and observed one staff (1) and nine (9) active day care children one (1) sick napping day care child (isolated) in off limits area.

LPA's toured inside and outside and observed a trampoline on the premises without the spring pad covered. The manufacturer is Acwarm Home, and the licensee does not have the instructions and guidelines. Per the Licensee, the trampoline will be removed due to the wind blowing off the netting and padding that covers the springs therefore, LPA's recommended it be removed from the day care area.

As a result, LPAs observed the day care home to be operating out of ratio. Per Title 22, Division 12, Chapter 1, there is one there is a Type A deficiency cited during this inspection. See 809 D page.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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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: YARBER FAMILY CHILD CARE
FACILITY NUMBER: 367700236
VISIT DATE: 02/07/2024
NARRATIVE
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signed acknowledgment of Licensing Reports (LIC 9224) form from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview was conducted, a copy of this report was read, and a Notice of Site Visit and Appeal Rights were provided to Licensee at the facility. A Notice of Site Visit must be posted for thirty (30) consecutive days, failure to comply with posting will result in $100 civil penalty.

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

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/07/2024 04:12 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 02/07/2024 at 03:51 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: 367700236

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
02/08/2024
Section Cited
CCR
102416.5(e)

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102416/5 (e)If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidenced by:
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Licensee will provide a written declaration stating how not to allow this to occur in the future and provide to Licensing by POC date 2/8/2024.
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Based on observation and interview LPAs observed one facility representative assisting nine active day care childrend and one napping day care child alone which poses an immediate health, safety, or personal rights risks to the persons 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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


LIC809 (FAS) - (06/04)
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