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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415102
Report Date: 01/25/2023
Date Signed: 01/25/2023 04:27:06 PM


Document Has Been Signed on 01/25/2023 04:27 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:CCRC HEAD START-OSBORNEFACILITY NUMBER:
197415102
ADMINISTRATOR:ANGELEE OSTERFACILITY TYPE:
850
ADDRESS:13821 OSBORNE STREETTELEPHONE:
(818) 830-1369
CITY:ARLETASTATE: CAZIP CODE:
91331
CAPACITY:80CENSUS: 35DATE:
01/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Anit AyvazyanTIME COMPLETED:
04:30 PM
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On 1/25/2023 Licensing Program Analyst (LPA)Isabel Ortega met with facility Director and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA observed 35 children and 7 staff providing care and supervision today. Facility Operates in three room referred to as the Classroom #1, #2, #3.
There are a total of three classrooms, one play yard and two sheds in the play yard(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 dispenser for indoor drinking water with individual one-time disposable cups for children. During outdoor play children are provider filter water in a a water jug and disposable cups for children. An isolation area was inspected, which takes place in the Directors main office space. Children have the option for rest time and quiet time if needed(cots and sheets are provided by the facility). 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 school facility’s on-site custodian.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/25/2023
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Facility operates Monday through Friday regular and extended CSPP State Program. Regular program is Monday through Friday from 7:30 a.m. to 3:30 p.m. and Extended CSPP State Program Monday through Friday from 7:30 a.m. to 5:30 p.m.
First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers were observed and in operable condition. Smoke and carbon monoxide tested operating according to fire marshal standards. Trash cans with tight lids were observed. The center participates in a Food Nutrition Program and provides breakfast, lunch and afternoon snack for children enrolled. Food for the children is brought and prepared from an outside vendor. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. There is hot running water in the staff lunch room where food is kept in a refrigerator and portable warmers to keep food at proper temperature. The staff room is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 12/13/2022 at 10:00 a.m. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal codes and standards (last serviced 08/11/2022). Food allergies are noted and are posted in the food preparation area and in each classroom.

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 water jugs and disposable one time use cups during outdoor play. 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. There are two sheds on the play area utilized for equipment and storage (maintained locked).

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

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
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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: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/25/2023
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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.

Director 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 11/23/2023.

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

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
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: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/25/2023
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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.

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 in compliance, no deficiency will be issued today. An exit Interview was conducted with Director Anit Ayvazan. 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: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
LIC809 (FAS) - (06/04)
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