197413999-12-1-2023-12-CC-IORA-CY522U-20231201160119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413999
Report Date: 12/01/2023
Date Signed: 12/01/2023 04:01:27 PM

Document Has Been Signed on 12/01/2023 04:01 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:	VOA GRANTEE/MARTIN LUTHER KING HEAD START		FACILITY NUMBER:	197413999
ADMINISTRATOR:	ESCOBAR, SHEILA		FACILITY TYPE:	850
ADDRESS:	10896 LEHIGH AVE		TELEPHONE:	(818) 834-9097
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY: 50	TOTAL ENROLLED CHILDREN: 50	CENSUS: 0	DATE:	12/01/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Angelica Castillo, Site Supervisor		TIME COMPLETED:	04:15 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 12/01/2023 Licensing Program Analyst (LPA) Isabel Ortega met with Site Supervisor Angelica Castillo and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA did not observe any children in care. During the time of the inspection nine Staff were present. Facility Operates in four classrooms referred to as Head Start classroom #1 and classroom #2 and Early Head Start classroom #1 and classroom #2. There are a total of two buildings with two classrooms on each side. Each side has a kitchen area. There are two areas for outdoor play utilized by both the Early and Head start program. There are two sheds on the facility (maintained locked) utilized for equipment, material and storage. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed individual storage with labeled children’s name for belongings. An isolation area was inspected, which takes place in the main office (mats are available). Children have the option for rest time and quiet time if needed.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: VOA GRANTEE/MARTIN LUTHER KING HEAD START	FACILITY NUMBER: 197413999
	VISIT DATE: 12/01/2023

NARRATIVE

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Cots are available and are labeled with children's name. Blankets and bedding sheets are provided by the facility and taken home weekly (Friday) for wash. Age-appropriate sinks and toilets were inspected for availability and in good repair. Toilets flush 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 of toiletries, and sanitized by custodian daily and as needed. Staff clean and disinfect classrooms, restrooms and restocks of toiletries daily.

Facility operates a Head Start program Monday through Friday from 8:15 a.m. to 2:30 p.m. and an Early Head Start Program ages 2 years to 3 years Monday through Friday from 8:00 a.m. to 3:00 p.m.

Food allergies are noted in each classroom and food preparation area, on the refrigerator. Facility provides breakfast, lunch and afternoon snack. Filtered water is provided from a filtered water dispenser for indoors and disposable cups are available.
Licensee had all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, and Earthquake Preparedness Checklist.

First Aid supplies/kit is complete, the smoke detectors, carbon monoxide detector Dual(tested at 1:45 p.m.) are operating properly. The fire Extinguisher(2A10BC) is reading in green(last serviced on 11/02/2023) and meets the State Fire Marshal codes and standards.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: VOA GRANTEE/MARTIN LUTHER KING HEAD START	FACILITY NUMBER: 197413999
	VISIT DATE: 12/01/2023

NARRATIVE

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Emergency Drills are conducted every month last drill recorded was on 11/27/2023 at 10:00 a.m.

Trash cans with tight lids were observed. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. The kitchen area is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children. The menu is posted in the kitchen area and visible to parents. The menu is also posted on Learning Genie and parents are provided with a tangible copy upon request.

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 with adequate resilient cushioning material underneath and around the perimeter. Children are provided with non-contaminated water from a filtered water dispenser, disposable cups are available. During outdoor play an igloo container is filled and disposable cups are provided.

The playground is well fenced all around, and no bodies of water observed on the outdoor play area. There is adequate shade area for rest.

Facility maintains adequate teacher child ratio. Care and supervision were evaluated and determine basic needs of children are appropriate and are being met. The parent board was reviewed and has all the required forms posted and visible.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: VOA GRANTEE/MARTIN LUTHER KING HEAD START	FACILITY NUMBER: 197413999
	VISIT DATE: 12/01/2023

NARRATIVE

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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 and all staff have been fingerprinted and association to the designated license number.

Directors and teachers are currently certified in Pediatric CPR/First Aid which expires until 06/16/2025. Child Care Provider Mandated Reporter (AB1207) training is dated 11/20/2023.

The following Incidental Medical Services (IMS) were discussed.
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

All staff are required to take 3-hour Child Care Provider Mandated Reporter(AB1207) training every 2 years. www.mandatedreporterca.com.

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

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: VOA GRANTEE/MARTIN LUTHER KING HEAD START	FACILITY NUMBER: 197413999
	VISIT DATE: 12/01/2023

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. 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.

Director is aware all staff are mandated child abuse reporters and are required to 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

For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

Per Title 22 Regulations facility is in compliance, no deficiency will be issued today. An exit Interview was conducted with Site Supervisor Angelica Casillo. A copy of this Report, a Notice of Site Visit(NOA) and appeal rights were provided on this day.

A copy of this report must be made available to the public for 3 years. The NOA shall be posted visible to parents for 30 days.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC809 (FAS) - (06/04)

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