197404676-5-22-2019-12-CC-BREO-BCETEW-20190522144036

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197404676
Report Date: 05/22/2019
Date Signed: 05/22/2019 02:40:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	PALMDALE SCHOOL DISTRICT-MESQUITE SCHOOL HEAD STAR		FACILITY NUMBER:	197404676
ADMINISTRATOR:	LEBETSAMER, DONNA		FACILITY TYPE:	850
ADDRESS:	37622 43RD ST. EAST		TELEPHONE:	(661) 273-4710
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93552
CAPACITY:	44	CENSUS: 17	DATE:	05/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Joe Vega-Smith		TIME COMPLETED:	02:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/22/2019 at 1:00 p.m. Licensing Program Analyst (LPA) Brianna Reynoso was greeted by above facility’s site supervisor, Susan Zapata. LPA was at the facility to conduct an unannounced random annual inspection. LPA disclosed the purpose of the visit and was granted entry to the facility by Staff 1. At 1:20 p.m., LPA met with facility's School Readiness Coordinator, Joe Vega-Smith. The facility operates two half day programs. The morning program operates from 8:00 a.m. to 11:30 a.m., and the afternoon program operates from 12:30 p.m., to 4:00 p.m. Per the Site Supervisor, the facility does not transport any children. The facility uses Classroom 42 for their head start program, which is located to the left of the elementary school entrance. Upon entering Classroom 42, LPA verified a census of 17 children and two staff members. Furniture and equipment were inspected for operable conditions and age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage for children's belongings. Children have access to water through a water dispenser and disposable water cups located inside of the classroom. The facility uses the Site Supervisor's office to isolate sick children. The facility does not offer nap time as a part of their daily activities as they operate half day programs. Age appropriate sinks and toilets were inspected. Toilets flush properly; toilets and sinks are reachable by the children. LPA inspected the restroom inside of Classroom 42. Toilets and sinks were in operable condition and met the Title 22 requirements. School Readiness Coordinator stated staff had a separate restroom which was located on the elementary school site.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: PALMDALE SCHOOL DISTRICT-MESQUITE SCHOOL HEAD STAR	FACILITY NUMBER: 197404676
	VISIT DATE: 05/22/2019

NARRATIVE

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First Aid supplies, smoke detector, carbon monoxide and fire extinguishers were observed and in operable condition. The fire extinguisher (2A10BC) had a service tag attached indicating it was last serviced on 12/21/2018. Trash cans with tight lids were observed. The elementary school provides breakfast, snack, and lunch for the children in care. The kitchen area was adequately equipped, clean, and free from hazards. Menu was posted, dated, and accessible for parent’s review. LPA observed an allergy list posted on the refrigerator in the kitchen area.

The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, conditions and age appropriateness. Climbing structures, slides, and play equipment were found to be securely anchored with resilient cushioning material underneath and around the perimeter. Children have access to water through water pitchers and disposable cups during outdoor activities. The playground is fenced all around, and no bodies of water observed in the outdoor play area. The playground area has a shaded rest area for the children.

Staff files and roster are kept at the Head Start District Office, however School Readiness Coordinator provided LPA with the documents during the inspection.

Children files were reviewed and found to be complete. The facility roster and fire drills were up to date, and all staff have been fingerprint cleared. Site Supervisor has a current CPR and Pediatric First Aid certification, which expires on 10/30/2019. The parent board was reviewed and had all of the required forms posted and accessible to parents.

LPA observed medications stored in an inaccessible plastic box, which the facility keeps in a cabinet to the left of the kitchen area sink.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: PALMDALE SCHOOL DISTRICT-MESQUITE SCHOOL HEAD STAR	FACILITY NUMBER: 197404676
	VISIT DATE: 05/22/2019

NARRATIVE

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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

The following was discussed with the School Readiness Coordinator:

Smoking is prohibited on the premises of a child care center; Infant walkers, baby jumpers, exersaucers, baby rockers and any other item that falls into that category are prohibited; Earthquake safety and necessity of drills are to be conducted every 6 months and logged; Required forms for children’s files, facility files, staff files, and posting requirements; Fingerprint clearances and the transfer process.

The School Readiness Coordinator was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at
childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The above facility was found to be in substantial compliance, and no deficiencies were cited during today’s inspection.

An exit Interview was conducted, a copy of this report, and notice of site visit were provided to School Readiness Coordinator, Joe Vega-Smith.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

LIC809 (FAS) - (06/04)

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