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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409310
Report Date: 03/28/2023
Date Signed: 03/28/2023 02:22:40 PM


Document Has Been Signed on 03/28/2023 02:22 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:LANCASTER-SIERRA ELEMENTARY STATE PRESCHOOLFACILITY NUMBER:
197409310
ADMINISTRATOR:FOUNTAIN, KELLYFACILITY TYPE:
850
ADDRESS:747 WEST AVE. J-12TELEPHONE:
(661) 942-4382
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:96CENSUS: 70DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Coordinator-Christy DepasqualeTIME COMPLETED:
02:30 PM
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On 3/28/2023 at 10:00am, Licensing Program Analyst (LPA) Andrea Pittman arrived at the facility to conduct an Annual Random Inspection. LPA was met by Coordinator Christy Depasquale and toured the facility in accordance with the facility sketch. During the inspection, LPA observed 70 children and 11 staff providing care and supervision. Facility operates Monday through Friday from 8:00am to 3:30pm.

Facility consists of a total of six rooms: four classrooms: PS 1, PS 2, PS 3, and PS 4, one staff bathroom, four children’s bathroom inside the classrooms, 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 filtered water in large drinking containers dispensed in individual, one-time use disposable cups. An isolation area was inspected and located near a separate restroom. Children are provided napping and age appropriate and individual bedding and mats were observed in the full day classrooms: PS 2 and PS 4 and napping is available in the calming area but not provided as part of the daily activity in PS 1 and PS 3. Age-appropriate sinks and toilets were inspected for availability and good repair; adequate sinks and toilets were available for the number of children present inside the classrooms. 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.

Smoke detectors, carbon monoxide detectors, and fire extinguishers were observed and in operable condition. Smoke and carbon monoxide detectors are operating according to Fire Marshall standards. First Aid Kit shall be complete with the following supplies including tweezers, scissors, guaze, bandages, cleansing pad/solution, thermometer, and a first aid manual.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2023
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: LANCASTER-SIERRA ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 197409310
VISIT DATE: 03/28/2023
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At 10:48am, LPA observed tweezers missing from the first aid kit in PS 1; at 11:25am and 11:52am, tweezers, scissors, and first aid manual was missing from PS 3 and 4. LPA observed the Coordinator addressed the missing first aid required items, this is a Technical Violation. Trash cans with tight lids were observed. Cleaning supplies, hazardous materials, and/or poisons are found to be out of the reach of children and locked under the sink or in a locked cabinet.

Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 3/9/2023 at 8:10am for the Fire Drill and 10/27/2022 at 10:30am for the Emergency/Earthquake Drill. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal Codes and Standards (last serviced 6/19/2022 and 6/20/2022). 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 on a pink log on the refrigerator. There is no outside food allowed and the center provides breakfast, lunch, and no snacks. Transportation is not provided by the center.

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. At 12:01 pm, LPA observed inadequate resilient cushioning material underneath and around the perimeter of the climbing structure; Coordinator addressed the inadequate cushioning material by rearranging the material to be at minimum three to six inches in depth. At 12:08 pm, LPA observed broken handles on two of the tricycles, the Coordinator addressed the inefficiency by moving the two broken tricycles to the outdoor shed making it inaccessible to children in care. Children are provided with filtered water via an igloo container and disposable, one-time use cups during outdoor play. There is adequate shaded area for rest. The playground is well-fenced, all around. At 12:15 pm, LPA observed there were flower beds with water inside in the outdoor play area that weren’t in use. LPA observed the Coordinator emptying the water from the flower beds making it inaccessible to children in care. The corrections by the Coordinator for the flower bed, cushioning material, and broken tricycle handles are a technical violation as they do not pose immediate or potential risk to children in care.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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: LANCASTER-SIERRA ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 197409310
VISIT DATE: 03/28/2023
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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 and accessible to parents.

Records/Documentation:
Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file.
The facility roster was up to date, posted, and all staff have been fingerprinted and association to the designated license number through Title 5 Regulations. Personnel records were reviewed for completeness. Teacher personnel files are current and the Pediatric CPR/First Aid, expires until 03/14/2023. Child Care Providers (AB1207) Mandated Reporter Training certificate is dated 7/6/2022; there is a waiver on file for the school to complete their own Mandated Reporter Training.

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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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

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

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: LANCASTER-SIERRA ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 197409310
VISIT DATE: 03/28/2023
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All staff are required to take 3-hour Child Care Provider Mandated Reporter training (AB1207)every 2 years.

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

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. Facility Representative 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.



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.

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

Per Title 22 Regulations, this facility is incompliant and Technical Violations have been issued; review the LIC 9102TV for further information regarding the technical violations. An exit interview was conducted with Coordinator Christy Depasquale 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: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4