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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910831
Report Date: 03/30/2022
Date Signed: 03/30/2022 12:36:21 PM


Document Has Been Signed on 03/30/2022 12:36 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:PSD/APPLE VALLEY HEAD STARTFACILITY NUMBER:
360910831
ADMINISTRATOR:DOLORES EDWARDSFACILITY TYPE:
850
ADDRESS:13589 NAVAJO ROADTELEPHONE:
(760) 247-6955
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY:117CENSUS: 19DATE:
03/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:LINDA WALKERTIME COMPLETED:
12:55 PM
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Licensing Program Analysts (LPA) Babatunde Ibitoye met with Site Supervisor Linda Walker , today for the purpose of conducting an unannounced Annual/Random inspection for the Pre-School. There are 14 children present upon arrival with 2 teacher in classroom 1 and.5 Children with 2 teacher in Classroom 2, Per site supervisor the hours of operation are 7:00 AM - 5:00 PM Monday - Friday. The Center also has an Pre school component.

LPA verified there is at least 1 staff person present with current CPR and First Aid training (exp. 11-13-23)
*Snack/lunch menus, Allergy list were reviewed and posted. Food and snacks were reviewed for availability, quantity, proper storage, and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. (1 freezer 1 refrigerator, sink, stove/oven).
*Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored in storage locked cabinet.
* LPA observed 6 Classrooms, Bathrooms (9) noted all toilets (9), sinks (7) were sanitary and operational. LPAs observed soap, paper towel and toilet paper and water tested at a safe temperature. Each classroom has a bottle water, disposable cups, cubbies with children's names identified and cots.
*All flooring was found to be clean and safe.
**Teacher/child ratio observed, care and supervision was discussed, children's records were reviewed, parent board observed and fire drills are current. Fire extinguisher operable.
*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.
*First Aid supplies were inventoried, a review of medication policy, including administering, labeling, and storage. *Telephone service, heating, lighting and ventilation were evaluated.
*Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness, LPAs noted shade, and drinking water: There are no bodies of water on the premises.
*Isolation area is located in the front Office.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD/APPLE VALLEY HEAD START
FACILITY NUMBER: 360910831
VISIT DATE: 03/30/2022
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ADMINISTRATION:
*Site Supervisor is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.
*There were no excluded individuals present; staff present were fingerprint cleared and associated, LPAs and Site Supervisor reviewed Personnel Report (LIC 500) together during this inspection.
A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Supervisor administers medication and documents the dosage, date and time onto a log. Medication brought and taken home by the parent daily. Medication is properly labeled and stored in its original container.

LPA discussed the following:
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include:
· Serious health and safety violations resulting in Type A citations;
· Non-compliance conferences; or Efforts by the Department to revoke a facility’s license. Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Failure to meet the posting requirements shall result in an immediate civil penalty. In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to
.Center was found to be operating within its specified ratio and capacity.
Children file were reviewed and contained emergency contact information, staff files were reviewed and contained qualifications.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD/APPLE VALLEY HEAD START
FACILITY NUMBER: 360910831
VISIT DATE: 03/30/2022
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There are no deficiencies are being cited in accordance to Title 5 of the California Code of Regulations and/or Health & Safety codes. LPA's issued 1 Technical Assistance (TA) for expired Mandated reporter training. Mandated reporter training on record Expired 3/18/2022.

§1596.8662 (b) (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. - www.mandatedreporterca.com


Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.
Exit interview conducted with Site Supervisor Linda Walker.. A copy of the Appeal Rights (LIC 9058) were given and explained. Site supervisor signature on this form acknowledges receipt of these rights.



SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
LIC809 (FAS) - (06/04)
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