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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700283
Report Date: 09/21/2022
Date Signed: 09/21/2022 02:15:38 PM

Document Has Been Signed on 09/21/2022 02:15 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:MCDOWELL FAMILY CHILD CAREFACILITY NUMBER:
367700283
ADMINISTRATOR:PATIENCE MCDOWELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 596-7315
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
09/21/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Licensee Patience McDowellTIME COMPLETED:
02:30 PM
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On September 21, 2022, Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced case management inspection to the family child care home. The purpose of the unannounced inspection was to follow up on a matter unrelated to this inspection. LPA announced the reason for the unannounced inspection and the Licensee granted LPA access to the home. Present during today’s inspection were six children (three infants and three preschool age children) the Licensee and one staff member were providing supervision.

During the inspection, LPA observed staff 1 (S1) and two preschool age children in the garage. Interviews conducted by the LPA during the inspection confirmed the garage is used for preschool activities. Furthermore, the Licensee stated bedroom 1 has been utilized during nap time. Per the Pre Licensing inspection conducted on July 7, 2022, the garage and bedroom 1 are "off limit" areas and are not to be used for child care activities. Prior to utilizing the garage and bedroom 1 the Department did not receive notification from the Licensee.

Based on LPAs observation and interviews, the licensee did not give prior notice to the Department when the Licensee changed the garage and bedroom 1 from being off limits to an area where care and supervision is provided to children in care. Therefore a Type B citation is being issued for regulation 102416.3 (a)(6) Alterations to Existing Buildings or Grounds. This poses/posed a potential health, safety or personal rights risk to persons in care. Refer to LIC 809D.

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

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2022
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 09/21/2022 02:15 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/21/2022 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: MCDOWELL FAMILY CHILD CARE
FACILITY NUMBER: 367700283

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/22/2022
Section Cited
CCR
102416.3(a)(6)

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102416.3(a)(6) Alterations to Existing Buildings or Grounds: Prior to making alterations ....Licensee shall notify the Department ..., the following: Any change ...of the family child care home previously identified as "off limits" to an area where care and supervision ...provided to children in care.
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Per Licensee garage and bedroom 1 will not be utilized. Licensee will submit email notification to the Department to utilize bedroom 1 as an on limit area.
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This requirement is not met as evidenced by: Based on LPA observation and interviews conducted the garage and bedroom 1 are being utilized for care and supervision. These areas were identified as off limits during the pre licensing inspection. The Department was not notified of the change.
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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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022


LIC809 (FAS) - (06/04)
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