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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808238
Report Date: 05/11/2023
Date Signed: 05/11/2023 05:51:29 PM


Document Has Been Signed on 05/11/2023 05:51 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:PIERCE STATE PRESCHOOLFACILITY NUMBER:
153808238
ADMINISTRATOR:MICHELLE A ARMSTRONGFACILITY TYPE:
850
ADDRESS:674 N. GOLD CANYONTELEPHONE:
(760) 499-1679
CITY:RIDGECRESTSTATE: CAZIP CODE:
93555
CAPACITY:24CENSUS: 17DATE:
05/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Program Director Michelle ArmstrongTIME COMPLETED:
06:00 PM
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On 5/11/2023 at 2:35pm, Licensing Program Analyst (LPA) Andrea Pittman arrived at the facility to conduct an Annual Random Inspection. LPA was met by Site Supervisor Gabriela Hurtado and permitted to enter the facility; later Program Director Michelle Armstrong joined in the inspection. Program Director Michelle Armstrong guided the LPA on a tour of the facility in accordance with the facility sketch. During the inspection, LPA observed 17 children and 4 staff providing care and supervision. Facility operates Monday through Friday from 7:30am to 4:30pm.

Facility consists of a total of 6 rooms/areas: one classroom, one office, one kitchenette, one staff bathroom, one children’s bathroom, and one outdoor play area.

Indoor Activity Space:
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed sign-in sheets completed by each parent/guardian per requirements. LPA observed individual storage for children's belongings. The children have access to water via water bubbler at kid’s sink in the classroom and individual water bottles brought from home; Per the Program Director Michelle Armstrong, the Center has had the water tested for lead exceedances. An isolation area was inspected and located near a separate staff restroom. Children are not provided napping but there is a calming/resting area for children, if needed, in the cozy cubes. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flushed properly; toilet and sinks are reachable by the children. Each restroom has adequate toilet paper, hand soap, and paper towels available. Restrooms are cleaned, restocked with toiletries, and sanitized by on-site staff.


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SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
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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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: PIERCE STATE PRESCHOOL
FACILITY NUMBER: 153808238
VISIT DATE: 05/11/2023
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Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 5/1/2023 at 9:30am for the Fire Drill and 4/21/2023 at 2:00pm for the Emergency/Earthquake Drill. The fire extinguisher (3A40BC) is reading in green and meets the Fire Marshal Codes and Standards (last serviced 7/14/2022). Menus are posted at least a week in advanced, dated, and in sight of parents to review. Daily activity schedules are posted showing meal/snack times, nap time (if given), and specific activities. Food allergies are noted and are posted in the kitchen on a pink paper on the fridge. There is outside food allowed but is store bought only and the center provides breakfast, lunch, and no snacks.

Outdoor Activity Space:


The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair, and age appropriateness. Climbing structures and other play equipment were found to be securely anchored with adequate, resilient cushioning material underneath and around the perimeter. Children are provided water from the water bubbler and individual drinking bottles during outdoor play. The Center has had the water tested for lead exceedances. There is adequate shaded area for rest. The playground is well-fenced, all around and no bodies of water were observed in the outdoor play area.

Facility maintains an adequate teacher-child ratio. Care and supervision were evaluated and determined basic needs of children are appropriate and are being met. The parent board was reviewed and has all the required forms posted accessible to parents.

Records/Documentation:
Children's records were reviewed for completeness. Health History, Emergency contact, ID and consent, and Medical Exams; Immunization Records are all in the children's file.

Personnel records were reviewed for completeness. Director and teachers are currently certified in Pediatric CPR/First Aid, expires until 6/18/2023. Child Care Providers (AB1207) Mandated Reporter training certificate is dated 6/20/2022. LPA observed at 4:34pm that Staff 1 does not have TB results which is a Type B violation, see the LIC 809D for the details.

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SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
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: PIERCE STATE PRESCHOOL
FACILITY NUMBER: 153808238
VISIT DATE: 05/11/2023
NARRATIVE
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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Upon hire date, all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

All staff are required to take 3-hour Child Care Provider Mandated Reporter training (AB1207) every 2 years. Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hot-line at (800) 540-4000.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: PIERCE STATE PRESCHOOL
FACILITY NUMBER: 153808238
VISIT DATE: 05/11/2023
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For additional information and forms visit our website at: www.cdss.ca.gov

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


For updates on Community Care Licensing, please visit the following website at: Childcareadvocatesprogram@dss.ca.gov

A copy of this report must be made available to the public for 3 years.

Per Title 22 Regulations, facility is not in compliance, a Type B Deficiency has been cited. Please, see the LIC 809D for the citations.

An exit interview was conducted with Program Director Michelle Armstrong and a copy of this Report, a Notice of Site Visit, and Appeal Rights were provided on this day.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 05/11/2023 05:51 PM - It Cannot Be Edited

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: PIERCE STATE PRESCHOOL
FACILITY NUMBER: 153808238

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(a)(12)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the Licensee did not comply with the section cited above by not having tuberculosis test documents in Staff 1 personnel file which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 05/25/2023
Plan of Correction
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Licensee will provide the tuberculosis test documents for Staff 1 via e-mail, fax, or mail no later than 5/25/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5