263808342-6-29-2023-12-CC-KZIS-CT9TMZ-20230629145157

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 263808342
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:52:15 PM

Document Has Been Signed on 06/29/2023 02:52 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:	MAMMOTH KIDS CORNER		FACILITY NUMBER:	263808342
ADMINISTRATOR:	TELLER, DEBBIE		FACILITY TYPE:	830
ADDRESS:	77 FOREST TRAIL		TELEPHONE:	(760) 934-4700
CITY:	MAMMOTH LAKES	STATE: CA	ZIP CODE:	93546
CAPACITY:	12	CENSUS: 2	DATE:	06/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:50 AM
MET WITH:	Facility Staff Brittany Machado		TIME COMPLETED:	12:30 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 June 29, 2023 at 07:50 a.m. Licensing Program Analyst (LPA) Kendal Zirbes met with facility staff Brittany Machado. The purpose of the inspection was to conduct a required one year inspection at the licensed facility. LPA disclosed the purpose of the inspection to the facility representative. Present during today’s inspection were two infant age children, one teacher and two additional staff. The infant area consists of one classroom. The center also operates a preschool program (263808720). The preschool program is separate from the infant program. Common spaces for the programs consist of the facility kitchen, staff restrooms and staff office. The center operates year round Monday - Friday 7:30 a.m. - 5:15 p.m. Physical plant inspection was started at 10:00 a.m. Indoor/Children's Area: Infant center is equipped with appropriate furniture and equipment. Furniture and toys were maintained in good repair, safe condition and was age appropriate. LPA did not observe sharp points or edges, or small parts that could be swallowed. Per facility staff equipment, toys and furniture are sanitized daily or more often as necessary. There was a handwashing sink within arms length of the changing tables. No infant is left without supervision nor left unattended. The facility is in compliance with the staff/infant ratio and is not exceeding the approved capacity for the facility. LPA observed trash cans for solid waste have tight fitting lids. All materials and surfaces are toxic free. No fireplaces were present. There are carbon monoxide detector, smoke detector and Fire Extinguishers located throughout the Center. The Center had working telephone service on the premises. There is an isolation area for children who become ill while in care. The facility maintains a comfortable temperature at all times. Water is available through personal sippy cups filed from the kitchen faucet. Used diapers are put in a contained with a lid in a closed cabinet. Each infant has a container labeled with their name for the storage of personal items. Evacuation cribs available. No smoking is allowed on the premises. LPA did not observe baby walkers or other prohibited play equipment on the premises. Report Continued on page two

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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: MAMMOTH KIDS CORNER	FACILITY NUMBER: 263808342
	VISIT DATE: 06/29/2023

NARRATIVE

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Report continued from page one
LPA observed a cracked window behind changing table. The cracked window was not in the activity space. The crack was L-shaped, with an approximate 14 inch vertical and horizontal crack. Per conversation with facility staff the cracked window has been present for over one month. A type B citation was issued for this observation, refer to LIC 809D. In addition, LPA observed a approximate one inch area, where the formica kitchen counter was missing. LPA advised the Center to monitor the kitchen counter to ensure the area is in good repair and can be sanitized, disinfected and cleaned.
Napping: LPA observed cribs. LPA observed the crib mattresses were made of a cleanable vinyl material and were in good repair. The sleeping area is separated from the infant activity space by a dutch door. Sheets are cleaned and changed everyday or more often as necessary. LPA and facility staff discussed regulations 101429 (a)(2) and 101429 (a)(2)(D) Responsibility for Providing Care and Supervision for Infants. Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. Window cords were inaccessible to children.
Restrooms: At this time all infants are in diapers the infant area does not have a bathroom. A diaper changing area was located in the infant classroom. The area was clean and sanitary during this inspection.
Kitchen: The kitchen was under construction at the time of this inspection. The kitchen was inaccessible via child safety gates. Parents provide the infants food. The Center provides snacks.
Outdoor: The infants have a separate outdoor space from the preschool program. Due to damage caused by the winter storm the infant outdoor play area was not being utilized at the time of this inspection. The area was inaccessible to the children via a three foot fence. At this time, staff take the infants on walks to enjoy outdoor time.
File Review: During the inspection LPA reviewed four infant files and four staff files. Based on LPA review C1's, C2, C3, C4 needs and service plan, including the LIC 9227 and feeding plan were not completed prior to the infants first day at the Center. In addition the initial plans and the updated plans were not signed by the authorized representative. A type B citation was issued, refer to LIC 809D. LPA review also revealed the date of the Needs and Service plan was not on the form. LPA advised the Center to add the date of the Needs and Service Plans to the forms so the facility can ensure the Needs and Services Plans are being updated quarterly as required. LPA advised the Center to have the authorized representative sign the plans to verify that he/she has participated in updating the plan. Advisory Notices were issued. 15 minutes safe sleep checks were being recorded electronically on the Brighwheel App. Staff files contained all required information. Report continued on page three

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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: MAMMOTH KIDS CORNER	FACILITY NUMBER: 263808342
	VISIT DATE: 06/29/2023

NARRATIVE

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Continued from page two
Facility Records
LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA asked for documentation related to the required Lead testing. Facility representative stated the required testing has not been completed yet however the facility is in the process of scheduling the Lead testing inspection. Per facility staff the building was constructed prior to 1/1/2010. Based on interviews, the center did not have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023. Therefore a type B citation was issued, refer to LIC 809D.
Postings:
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster, car seat law (PUB 269), emergency disaster plan.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.
At this time zero children were provided with prescribed medications.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Report continued

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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: MAMMOTH KIDS CORNER	FACILITY NUMBER: 263808342
	VISIT DATE: 06/29/2023

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on LPA observations, and record review, three type B citations were issued along with three advisory notices. Refer to LIC 809D

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Brittany Machado.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/29/2023 02:52 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: MAMMOTH KIDS CORNER	FACILITY NUMBER: 263808342
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above when a L-shaped crack measuring more than 14 inches was present in the window behind the diaper changing station, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/06/2023
	Plan of Correction
1 2 3 4	Per facility staff member the window will be replaced. Document will sent to CCL verifying the window had been replaced.

Type B

Section Cited

CCR

101419.2(a)

Infant Needs and Services Plan

(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in four out of four infant files reviewed did not have the needs and service plan completed prior to the infants first day. Which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/13/2023
	Plan of Correction
1 2 3 4	Per facility representative the enrolment packet will be undated to include all the components of the needs and service plan. A copy of the updated needs and service plan will be submitted to the Department. All newly enrolled infants will have the paperwork completed prior to enrollment.

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 King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

Page: 5 of 8

Document Has Been Signed on 06/29/2023 02:52 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: MAMMOTH KIDS CORNER	FACILITY NUMBER: 263808342
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on interview, the licensee did not comply with the section cited above when the child care center was not tested for lead contamination between 1/1/2020 and 1/1/2023, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/12/2023
	Plan of Correction
1 2 3 4	Per facility representative, the required lead testing will be scheduled by 7.12.23. A email will be submitted to the Department verifying the lead testing inspection has been scheduled.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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