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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414000
Report Date: 05/18/2023
Date Signed: 05/18/2023 12:53:41 PM


Document Has Been Signed on 05/18/2023 12:53 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/NORTH WALNUT HEAD STARTFACILITY NUMBER:
197414000
ADMINISTRATOR:BAMACA, L AND GUTIERREZ, SFACILITY TYPE:
850
ADDRESS:24823 NO. WALNUT STREETTELEPHONE:
(661) 253-2035
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY:30CENSUS: 24DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Edna WilsonTIME COMPLETED:
12:35 PM
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On 5/18/2023 Licensing Program Analyst (LPA) Isabel Ortega met with facility Site Director Edna Wilson and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA observed 24 children and seven staff providing care and supervision. Facility Operates in two classrooms referred to as the Class One and Class Two.

There is a total of two classrooms, one play yard and three sheds around the play yard (maintained locked) and utilized for equipment storage and emergency supplies.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed individual storage with children’s name labeled for children's belongings. The classroom consists of filtered water for indoor use individual disposable cups for children are available for indoor and outdoor use.

An isolation area was inspected, which takes place in the office space in the classroom.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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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Document Has Been Signed on 05/18/2023 12:53 PM - It Cannot Be Edited

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/NORTH WALNUT HEAD START
FACILITY NUMBER: 197414000

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Deficiency Dismissed
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review the facility did not comply with the section cited above facility was not able to provide a copy of water testing for lead levels in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/02/2023
Plan of Correction
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Facility will complete a water sample test for lead contamination levels and submit a copy to the Palmdale Regional office by email by due date above.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA GRANTEE/NORTH WALNUT HEAD START
FACILITY NUMBER: 197414000
VISIT DATE: 05/18/2023
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During nap time children are provided with cots and blankets are provided by the facility and taken home weekly for wash. Children have the option for rest time and quiet time if needed, comfortable privacy areas are available. Age-appropriate sinks and toilets were inspected for availability and 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 staff daily and or as needed.

Facility operates two educational sessions Monday through Friday from 8:15 a.m. to 2:30 p.m. and 8:00 a.m. to 2:15 p.m. Facility participates in the Food Nutrition program and provides children with breakfast, lunch and afternoon snack. Menu is posted visible to parents and copies are available per request. Food allergies are noted in the classroom and food preparation area.

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, smoke detectors, carbon monoxide(dual) and fire extinguishers were observed and in operable condition according to fire marshal standards.

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, and there is hot running water in the food preparation area. The kitchen area is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA GRANTEE/NORTH WALNUT HEAD START
FACILITY NUMBER: 197414000
VISIT DATE: 05/18/2023
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Emergency Drills are conducted every sixth month last drill was conducted and documented on 05/09/2023 at 9:00 a.m. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal codes and standards (last serviced 5/1/2023).

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 other play equipment were found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. Children are provided with filtered water in igloo containers with disposable cups available for children for indoor and outdoor play. The facility was not able to provide lead testing results under 5.5 ppb. A type B citation will be issued.



There is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed in the outdoor play area.
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 accessible to parents.
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.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA GRANTEE/NORTH WALNUT HEAD START
FACILITY NUMBER: 197414000
VISIT DATE: 05/18/2023
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Directors and teachers are currently certified in Pediatric CPR/First Aid which expires until 06/25/2023. Child Care Provider Mandated Reporter (AB1207) training is dated 11/22/2021.

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 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.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VOA GRANTEE/NORTH WALNUT HEAD START
FACILITY NUMBER: 197414000
VISIT DATE: 05/18/2023
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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. 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.
Director 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 Hotline 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/

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

Per Title 22 Regulations facility is not in compliance, one Type B deficiency will be issued today. An exit Interview was conducted with facility Site Director Edna Wilson. A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
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