360910831-4-4-2023-12-CC-BIBE-CQKS54-20230404133343

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360910831
Report Date: 04/04/2023
Date Signed: 04/04/2023 01:33:56 PM

Document Has Been Signed on 04/04/2023 01:33 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 START		FACILITY NUMBER:	360910831
ADMINISTRATOR:	DOLORES EDWARDS		FACILITY TYPE:	850
ADDRESS:	13589 NAVAJO ROAD		TELEPHONE:	(760) 247-6955
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92308
CAPACITY:	117	CENSUS: 59	DATE:	04/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:38 AM
MET WITH:	LINDA WALKER		TIME COMPLETED:	01:59 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 Required 1 year inspection for the Pre-School. There are 59 children present upon arrival with 11 teacher and 2 teacher Aide in 5 classrooms , Per site supervisor the hours of operation are 7:00 AM - 5:00 PM Monday - Friday.

During the time of the inspection, LPA observed and reviewed records to verified accuracy:
1. Sampling of children's (5) records (See LIC 857)

2. Sign in and Out sheets were inspected.

3. Emergency contact information observed

4. Parent board observed

5. Staff personnel files reviewed for educational and certification (See LIC 859 )

6. Pediatric CPR and First Aid training for one staff

7. Mandated Reporter Training

8. Emergency Fire Drills were current and up to date

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PSD/APPLE VALLEY HEAD START	FACILITY NUMBER: 360910831
	VISIT DATE: 04/04/2023

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LPA verified there is at least 1 staff person present with current CPR and First Aid training (exp. 12-11-23)
*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
The food is brought in from a private company twice a week, the food is kept in the freezer and refrigerator on site. The food service worker prepares food (micro-wave food). There is a clean fully equipped kitchen (off limits) with refrigerator, freezer, industrial microwave, separate sinks for preparing food and hand washing. The facility provides breakfast, lunch, snacks (morning, afternoon). Trash container in each classroom with tight fitting lid. Allergy lists are posted in kitchen. LPA observed an appropriate amount of food and snacks
*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.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PSD/APPLE VALLEY HEAD START	FACILITY NUMBER: 360910831
	VISIT DATE: 04/04/2023

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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.

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, .
A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Supervisor/ Teacher administers medication and documents the dosage, date and time onto a log. Medication is properly labeled and stored in its original container.
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: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PSD/APPLE VALLEY HEAD START	FACILITY NUMBER: 360910831
	VISIT DATE: 04/04/2023

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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.

On January 1, 2018, or before March 30, 2018, a person who is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatedreporterca.com

AB 290 - for each new license issued, at least one director or teacher at a childcare center or family child-care home shall have at least one hour of childhood nutrition training.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PSD/APPLE VALLEY HEAD START	FACILITY NUMBER: 360910831
	VISIT DATE: 04/04/2023

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--Site Supervisor advised visit www.shotsforschool.org for Immunization information.
--Site Supervisor was informed of responsibility to report suspected Child Abuse, 1-800-827-8724/760-243-6640
--Child Care Centers (Disaster Planning information):https://cccld.childcarevideos.org/child-care-center-operators/disaster-planning-and-fire-safety/
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Site Supervisor advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

There are no deficiencies are being cited in accordance to Title 5 of the California Code of Regulations and/or Health & Safety codes

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.

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 Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

LIC809 (FAS) - (06/04)

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