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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197406879
Report Date: 03/15/2023
Date Signed: 03/15/2023 12:22:38 PM


Document Has Been Signed on 03/15/2023 12:22 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:PALMDALE SCHOOL DISTRICT-OCOTILLO HEAD STARTFACILITY NUMBER:
197406879
ADMINISTRATOR:DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:38737 OCOTILLO SCHOOL DRIVETELEPHONE:
(661) 456-1347
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:64CENSUS: 47DATE:
03/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Joe Vega School CoordinatorTIME COMPLETED:
12:40 PM
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On 03/15/23 Licensing Program Analyst (LPA) Andrew Alemoh met with Lead Teacher Valerie Williams,Joe Vega (school coordinator), and Lisa Fowler (supervisor) today for the purpose of conducting an unannounced Annual/Random inspection. This Pre-School program is held on the grounds of Octollio Elementary School in Modulars A, B, and B-2 (Rooms A,B and B-2 are Head Start Programs). LPA toured and inspected all areas according to the facility sketch. Room A is an Inclusion classroom and had 17 children and 2 teachers Room B had 12 children and 3 Teachers: Room C had 14 children and 2 teachers. The facility consists of 3 classrooms which operate half day sessions: Mon - thru Friday from 7:45 am to 2:45 PM (AM Session).

**LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and safe and free of any Health or safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings will be kept in cubbies along the wall as you enter classrooms. Drinking water is available inside the classroom in the form of a water cooler and disposable cups.

**The children's bathroom is located inside each classroom, each bathroom has 2 toilets and 1 sink. The staff rest-room is located in an adjacent building. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
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: PALMDALE SCHOOL DISTRICT-OCOTILLO HEAD START
FACILITY NUMBER: 197406879
VISIT DATE: 03/15/2023
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**Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt. Staff are aware of required forms for children's files and forms that shall be posted after licensure.

ยง1596.8662 Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion

(b) (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements


Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.

There were no violations noted as a result of this inspection, center operating within the guidelines of Title 22 Regulations.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
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: PALMDALE SCHOOL DISTRICT-OCOTILLO HEAD START
FACILITY NUMBER: 197406879
VISIT DATE: 03/15/2023
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**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material and there is sufficient and adequate shade available. Large play equipment and structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available in the form of a water fountain and Igloos, there are no bodies of water on the campus.

**Snack and lunches are delivered from the school cafeteria of Ocotillo Elementary School. There is a food preparation area inside each classroom. Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage, menus observed and posted. Storage areas were inspected for inaccessibility of toxins and cleaning compounds to children in care.



**Parent Board contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid (expires 07/24). Sign in and out sheets were inspected and contain full legal signatures. There is a fully stocked first aid kit available and fully charged fire extinguisher and carbon monoxide detectors in place. Fire Drill/Earthquake log is February 2023.

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


Notice of Site Visit has been issued. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
LIC809 (FAS) - (06/04)
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