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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750004
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:16:29 PM


Document Has Been Signed on 10/20/2022 02:16 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:LEONA COX STATE PRESCHOOLFACILITY NUMBER:
197750004
ADMINISTRATOR:MILITZA GARCIAFACILITY TYPE:
850
ADDRESS:18643 OAKMOOR STREETTELEPHONE:
(661) 252-2100
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY:24CENSUS: 18DATE:
10/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Julie Escalante, site supervisor TIME COMPLETED:
02:30 PM
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On 10/20/22, Licensing Program Analysts (LPAs) Alemoh and Beneroso conducted a Case Management inspection in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPAs Alemoh and Beneroso met with the Julie Escalante, the purpose of the inspection was disclosed, and entry was granted. Upon arrival, LPAs observed 18 children and 3 staff present today.

LPA Beneroso received sample results for the drinking fountain and sink faucet in the facility on June 16, 2022. Facility was originally tested on June 11, 2022. Sample B, outdoor drinking fountain had a reading of 5.1 UG/L and sample D, sink faucet had a reading of 13 UG/L. Facility ceased use of the drinking fountain B and sink faucet D on June 29, 2022, same day they obtained the results. Both outlets were properly covered and put out of service after receiving the results. The program director submitted all documentation required and reported the initial results in a timely manner.

LPA Beneroso received documentation of the facility being retested on September 24, 2022. Facility received notification the drinking fountain B and Sink faucet D are safe to be used on October 5, 2022. LPAs observed the water fountains to be in operable conditions since they had been repaired and re-tested.

An exit interview was conducted, and a copy of this report was provided along with a Notice of Site Visit and appeal rights to site supervisor Julie Escalante.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022
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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