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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408048
Report Date: 08/09/2023
Date Signed: 08/09/2023 03:27:19 PM


Document Has Been Signed on 08/09/2023 03:27 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PREFACILITY NUMBER:
197408048
ADMINISTRATOR:DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:37500 50TH STREET EASTTELEPHONE:
(661) 575-8959
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:142CENSUS: 55DATE:
08/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Joe Vega-Smith, School Readiness CoordinatorTIME COMPLETED:
03:39 PM
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On Wednesday, August 9, 2023, at 11:15 am, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced inspection and met with School Readiness Coordinator (SRC) Joe Vega-Smith who guided LPA Rivera on a tour of the facility.

This is a head start preschool program at serves children ages 3 to 5 years. This program operates Monday to Friday 7:30 a.m. – 4:30 p.m. Sign in and out takes place at the main entrance area and childplus app. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Classrooms A, E and F are full time and classrooms B and D are half time. Classroom C is utilized as a conference room. Teacher and child ratio were observed.



At approximately 11:20 a.m. LPA entered classroom F. LPA Rivera observed 14 preschool children with staff #1, #2, and #3 present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed children’s personal belongings stored in their cubbies. LPA observed cleaning solutions stored inside top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight fighting lid in the classroom.

At approximately 11:27 a.m. LPA entered classroom E. LPA Rivera observed 12 preschool children with staff #4, #5 and #6 present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed children’s personal belongings stored in their cubbies. LPA observed cleaning solutions stored inside top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight fighting lid in the classroom.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PRE
FACILITY NUMBER: 197408048
VISIT DATE: 08/09/2023
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At approximately 11:43 a.m. LPA entered classroom B. LPA Rivera observed 6 preschool children with staff #7, #8 and #9 present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed children’s personal belongings stored in their cubbies. LPA observed cleaning solutions stored inside top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight fighting lid in the classroom.

At approximately 11:50 a.m. LPA entered classroom A. LPA Rivera observed 14 preschool children with staff #10, #11 and #12 present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed children’s personal belongings stored in their cubbies. LPA observed cleaning solutions stored inside top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight fighting lid in the classroom.

At approximately 12 03 p.m. LPA entered classroom D. LPA Rivera observed 9 preschool children with staff #13, #14, # 15 and #16 present. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed children’s personal belongings stored in their cubbies. LPA observed cleaning solutions stored inside top cabinet making it inaccessible for children to reach. LPA Rivera observed a step trash bin with a tight fighting lid in the classroom.

Heating lighting and ventilation were evaluated by LPA Rivera. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats located in classrooms and temperatures to be between 70-71 degrees. LPA observed the fire extinguishers located in classrooms and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 4/23/23 and 2/23/23. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. Carbon monoxide detectors are in classrooms. LPA tested the carbon monoxide detectors and are operable. Drills have not been conducted because school year just started August 3, 2023. LPA observed napping equipment to be in good condition and names on the cots. SRC Vega-Smith stated the ill isolation area takes place in the lead teachers office and utilized staff restroom located in the classrooms. First aid kit supplies are kept inside the classrooms and LPA observed the kits to be fully equipped. Per SRC Vega-Smith the
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PRE
FACILITY NUMBER: 197408048
VISIT DATE: 08/09/2023
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medication is stored inside a carrying bag located inside the cabinets. One child has prescribed medication with expiration date 6/2024. LPA Rivera asked if there are any poisons, firearms, weapons or bodies of water. SRC Vega-Smith stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water.

Restrooms are located inside the classrooms. LPA observed the restrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels. LPA observed a total of 10 toilets and 10 hand washing sinks. Ill/isolation area children utilize the staff restroom located inside the classrooms.



At approximately 12:54 p.m. LPA entered the outdoor play area to conduct and inspection. LPA observed 4 sheds closed and locked with a padlock. LPA observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed play equipment to be age appropriate and areas around or under high climbing equipment, are cushioned with granulated rubber mat. For adequate shade, LPA observed 2 sunshade sail triangles canopies. For outdoor water drinking, water pitchers and disposable cups are
provided.

Lead testing was conducted on 1/3/2023 no exceedance. This program provides breakfast, lunch and p.m. snacks. Meals and snacks are prepared at the Chaparral Academy cafeteria. A monthly menu is available and posted in the main entrance and in the learning Guine App. For water drinking, LPA observed water dispenser and disposable cups in the classrooms. LPA observed the kitchenette food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin. The facility was observed to be free of flies, other insects and rodents.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, monthly Menu and Daily Schedule. LPA observed sign in and out sheets and located by the entrance of the classrooms.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PRE
FACILITY NUMBER: 197408048
VISIT DATE: 08/09/2023
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LPA also reviewed the children roster and children files. LPA was not able to review the staff files as they are in Palmdale Unified School District Headquarters.

LPA observed staff Pearl Rollins Pediatric First Aid/CPR certification dated 8/23/21.SRC Vega-Smith has been informed mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com



School Readiness Coordinator Vega-Smith was reminded that all adults 18 and over, 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.

This facility provides Incidental Medical Services – IMS. 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.
Items discussed during this visit:

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.



3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PRE
FACILITY NUMBER: 197408048
VISIT DATE: 08/09/2023
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4.LIC 311A - Records to be Maintained at the Facility: LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza (or decline influenza), pertussis, and measles

9. Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.



10.Liability insurance was also discussed.

Today’s inspection no deficiencies were given.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PRE
FACILITY NUMBER: 197408048
VISIT DATE: 08/09/2023
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Lead Teacher Kelly Ballard.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023
LIC809 (FAS) - (06/04)
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