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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419242
Report Date: 10/12/2022
Date Signed: 10/12/2022 02:27:03 PM


Document Has Been Signed on 10/12/2022 02:27 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:CREATIVE YEARS NURSERY SCHOOLFACILITY NUMBER:
197419242
ADMINISTRATOR:DENISE BAYLISFACILITY TYPE:
830
ADDRESS:21710 GOLDEN TRIANLE ROADTELEPHONE:
(661) 254-0718
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:18CENSUS: 6DATE:
10/12/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Katri TyniTIME COMPLETED:
02:45 PM
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On 10/12/2022 Licensing Program Analyst (LPA) Barbara Beneroso was greeted by above facility’s Administrator, Denise Bayliss and Katri Tyni. The purpose of the visit is to conduct conduct an unannounced random annual inspection. LPA disclosed the purpose of the visit and was granted entry into the facility. Katri Tyni guided LPA on a tour of the facility.

The facility's operating hours are Monday through Friday 6:00 a.m. to 6:00 p.m. Per the Administrator, the facility does not transport any children. This is an infant program with a toddler component. The facility uses Classroom 2 for infants and Classroom 6 for toddlers. Food containers/ lunch boxes are properly stored and labeled, milk, and formula for the infants. The facility provides snacks for the toddler children in care, or bringing lunch from home. Per the Administrator, the facility is not enrolled in a food program.

Upon entering Classroom 2, LPA verified a census of three infants and one staff members, who is fingerprint cleared and associated to the facility. Upon entering Classroom 6, LPA verified a census of six toddlers and two staff members, all of which were fingerprint cleared and associated to the facility.

Furniture and equipment were inspected for operable conditions and age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage cubby for children's belongings. Children have access to water through water pitchers and water bottles, located inside of the classroom. Children also have personal water cups that were found to be properly labeled. The facility uses the Director's office to isolate sick children. Children are provided with cots for nap time or cribs. Administrator informed LPA that bedding was brought from home and washed weekly. In the infant's room the bedding is changed daily and facility provides it.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2022
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: CREATIVE YEARS NURSERY SCHOOL
FACILITY NUMBER: 197419242
VISIT DATE: 10/12/2022
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Children and staff files were reviewed and found to be complete. The facility roster and fire drills were up to date (last completed on May 10, 2022), and all staff have been fingerprinted and associated to the facility. The facility Director has a current CPR and Pediatric First Aid certification expires on , which expires on May 2023. During the inspection LPA observed adequate teacher child ratio in each classroom. The parent board was reviewed and had all of the required forms posted and accessible to parents. LPA observed medications that were properly labeled and inaccessible to children in care. The facility stores their medication in locked boxes which are kept inside of the control panel closet located directly across the Director's office.

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

The following was discussed with the Administrator:


Smoking is prohibited on the premises of a child care center; Infant walkers, baby jumpers, exersaucers, baby rockers and any other item that falls into that category are prohibited; Earthquake safety and necessity of drills are to be conducted every 6 months and logged; Required forms for children’s files, facility files, staff files, and posting requirements; Fingerprint clearances and the transfer process. LPA also provided Administrator with a copy of Safe Sleep Pin 20-24
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
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: CREATIVE YEARS NURSERY SCHOOL
FACILITY NUMBER: 197419242
VISIT DATE: 10/12/2022
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The LPA observed changing tables in each classroom that were within arms reach of a sink. Changing tables had padding covered with washable vinyl or plastic. Administrator informed LPA that there is no restroom that is used for the children enrolled in the toddler component.

First Aid supplies, smoke detector, carbon monoxide and fire extinguishers (2A10BC) were observed and are in operable condition. Trash cans with tight lids were observed. The infant food was stored inside of the infant classroom, in a refrigerator located to the left of the classroom entrance. The facility utilizes two kitchens, one located to the left of the toddler classroom and the other located in the half day program building. Food was inspected and it was properly labeled, stored, and within expiration date. Kitchen areas were adequately equipped, clean, and free from hazards. The kitchens have a sink and refrigerator, and each classroom has a microwave. Menu was posted, dated, and accessible for parent’s review. LPA observed an allergy list posted inside of the Director's office and inside of 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, conditions and age appropriateness. Climbing structures, slides, and play equipment were found to be securely anchored with resilient cushioning material underneath and around the perimeter. Children have access to water through water pitchers and disposable cups during outdoor activities. The playground is fenced all around, and no bodies of water observed in the outdoor play area. The playground area has a shaded rest area for the children. Per the Administrator, the infants use the left side of the outdoor play space, and the toddlers use the left and right side of the outdoor play space. When asked if the infants and toddlers are ever commingled during outdoor activities, Administrator stated the facility places an extended separation gate to ensure the children do not commingle.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC809 (FAS) - (06/04)
Page: 2 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: CREATIVE YEARS NURSERY SCHOOL
FACILITY NUMBER: 197419242
VISIT DATE: 10/12/2022
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The Administrator was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov


The above facility was found to be in substantial compliance and no deficiencies were cited during today’s inspection.

An exit interview was conducted, a copy of this report, and notice of site visit were provided to Administrator, .
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4