197407723-5-3-2023-12-CC-CHEH-CRGMRY-20230503095107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197407723
Report Date: 05/03/2023
Date Signed: 05/03/2023 09:51:22 AM

Document Has Been Signed on 05/03/2023 09:51 AM - 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:	PALMDALE SCHOOL DISTRICT - PALM TREE HEAD START		FACILITY NUMBER:	197407723
ADMINISTRATOR:	DR. MELANIE CULVER		FACILITY TYPE:	850
ADDRESS:	326 EAST AVENUE R		TELEPHONE:	(661) 265-1744
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93550
CAPACITY:	45	CENSUS: 34	DATE:	05/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:11 AM
MET WITH:	Joe Vega-Smith		TIME COMPLETED:	10:15 AM

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 5/3/2023, Licensing Program Analyst (LPA) Carol Heath met with the School Readiness Coordinator (SRC), Joe Vega-Smith and ECE Asst. Admin, Lisa Fowler , for the purpose of conducting an unannounced Annual/Random inspection. This Head Start Program is held on Palm Tree Elementary School grounds. LPA disclosed the purpose of the inspection and was granted entry. LPA toured and inspected the preschool in accordance with the facility sketch. This Head Start Program will occupy 2 classrooms (Rm A and B). The Center will operate 2 half-day classrooms Monday through Friday from AM: 7:45 am to 11:15 am and PM: 11:45 to 3:15 pm and will cater to children ages 3 yrs to 5 yrs. Upon arrival, LPA observed 2 classrooms in use with a total of 34 preschool children and 6 teachers on the premises. Incidental Medical Services (IMS) were discussed. LPA toured and inspected the 2 classrooms. Furniture and equipment were inspected for age appropriateness and good repair. The Center provides potty training. The coordinator mentioned that diaper changing is done standing. The telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings in each classroom. LPA observed age-appropriate toys and materials. Drinking water is available inside the classroom with a water pitcher and disposable cups. There are fire alarms and carbon monoxide detectors located by the doors of each classroom. Fire extinguishers are appropriately maintained.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PALMDALE SCHOOL DISTRICT - PALM TREE HEAD START	FACILITY NUMBER: 197407723
	VISIT DATE: 05/03/2023

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Both kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents, and any other vermin. Allergy lists are available in both classrooms. Storage containers for solid waste, including moveable bins, shall have tight-fitting covers kept on and in good repair. The weekly menu was observed at the entrance to classrooms. Food for morning and afternoon classes is brought daily from the Palmdale School District cafeteria next door. Chemicals and cleaning solutions are kept separate from the food in the classroom.
The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. A large play structure is securely anchored with a padded floor underneath for cushioning and a shaded area for rest. The area was observed to be free of debris. Drinking water is available as a water pitcher and disposable cups. The play area was inspected for hazards and inaccessibility to bodies of water.
LPA observed bathrooms in each classroom consisting of 2 toilets and 1 sink that is in working condition and age-appropriate. The covered trash bin is in the restroom. Staff uses a separate bathroom located beside Classroom 1. LPA observed soap, toilet paper, and paper towels readily available. Fire extinguishers, smoke detectors, and carbon monoxide detectors were observed to be operable. First Aid kits were also observed.
A Fire Drill/Earthquake log is posted and a current Roster is available.
The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PALMDALE SCHOOL DISTRICT - PALM TREE HEAD START	FACILITY NUMBER: 197407723
	VISIT DATE: 05/03/2023

NARRATIVE

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The Director administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily. Medication is properly labeled and stored in its original container. There are currently no children in care with IMS needs. There is a separate area for isolating and caring for ill children in the classroom. There is a mat available for ill children. An isolated toilet and sink are available for ill children in the classroom.
Sign-in and out sheets were reviewed. Teacher to child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if children’s basic needs were met and appropriate. LPA observed a parent board consisting of licensing-required postings. Sign-in and out sheets were reviewed.
Children's records and staff records were reviewed. LPA verified at least 1 staff person present with current CPR and First Aid Training (exp. 08/04/2025). Mandated Reporter expires 02/21/2025.
LPA reviewed 10 children's records; the records are complete with parent signatures.

The following general information was discussed during this inspection:

The 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PALMDALE SCHOOL DISTRICT - PALM TREE HEAD START	FACILITY NUMBER: 197407723
	VISIT DATE: 05/03/2023

NARRATIVE

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Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according 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.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. T
*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state licensed facility to another using form LIC 9184
**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 the report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt. Staff is aware of the required forms for children's files and forms that shall be posted after licensure.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PALMDALE SCHOOL DISTRICT - PALM TREE HEAD START	FACILITY NUMBER: 197407723
	VISIT DATE: 05/03/2023

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**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 childcare facility are aware of situations that present the greatest danger to children.

No deficiencies are being cited at this time; the facility complies with Title 22

Exit interview conducted with School Readiness Coordinator. A copy of this report is discussed and left with Joe Vega-Smith and Lisa Fowler.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC809 (FAS) - (06/04)

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