360911141-1-11-2023-12-CC-KZIS-CMYV2Y-20230111150355

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360911141
Report Date: 01/11/2023
Date Signed: 01/11/2023 03:04:21 PM

Document Has Been Signed on 01/11/2023 03:04 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:	PSD/DEL ROSA HEAD START		FACILITY NUMBER:	360911141
ADMINISTRATOR:	DEBBIE ARNOLD		FACILITY TYPE:	850
ADDRESS:	2382 DEL ROSA AVENUE		TELEPHONE:	(909) 883-0103
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY:	63	CENSUS: 26	DATE:	01/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Facility Representative Alicia Kokinacis		TIME COMPLETED:	03:20 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	Licensing Program Analyst (LPA) Zirbes met with the Facility representative Alicia Kokinacis for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the entire center, which consists of four classrooms, four children restrooms, one staff restroom, kitchen, lobby/reception area, outdoor play space. LPA observed three classrooms being utilized today with a total of 26 preschool children. The following staff were present: three teachers, three aides, along with additional clerical and housekeeping staff members. The facility operates from 7:00am until 4:30pm Monday through Friday. This Head Start Program currently offers full day and half day classes. Indoor/Children’s Area: Child care center was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in key locked cabinet in each classroom. Cleaning compounds were also stored in a high inaccessible cabinet in the kitchen. Per facility representative zero poisons are stored within the preschool. LPA observed the furniture/equipment was in good condition. Classrooms were free of flies, other insects and rodents. The classrooms had tables and chairs to meet the children's needs. LPA observed the Center has a variety of art supplies, dramatic play equipment, blocks, books, computer stations, and a wide variety of additional educational materials. Children's belongings are kept in cubbies labeled with the children's names. Trash cans for solid waste have tight fitting lids. Drinking water is readily available indoors via water cooler and cups. All materials and surfaces are toxic free, window screens in good repair and free of debris. There is a working carbon monoxide detector, smoke detector and multiple fire extinguishers located throughout the Center. There was a total of four restrooms in the preschool Center. Classroom 1/50 had one restroom with one sink and one toilet. Classroom 2/51 had two restrooms with two toilets and two sinks. Classroom 60 had two restrooms with two toilets and two sinks. Classroom 61 had one restroom with one toilet and one sink. 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: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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: PSD/DEL ROSA HEAD START	FACILITY NUMBER: 360911141
	VISIT DATE: 01/11/2023

NARRATIVE

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Report continued from page one Toilets and sinks were functioning properly and are age appropriate. LPA observed steep stools, soap, toilet paper and paper towels readily available.
There was working telephone service within the preschool. There is an isolation area for children who become ill. The facility maintains a comfortable temperature at all times. LPA observed the centers electronic sign in/out sheets, which are completed daily. Smoking is prohibited on the premises. Teachers conduct daily inspection for illnesses. LPA did not observe prohibited childcare items during this inspection. Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises. The Center provides breakfast lunch and one snack a day. The preschool utilizes a food vendor who brings the food to the facility each day. All food is heated and prepared in the kitchen area which was inaccessible to the children via a dutch door. The kitchen area was observed to be clean and orderly at the time of this inspection.
Napping
LPA observed mats for the children. LPA observed bedding was stored in a manner which does not allow different children's bedding to come into contact with each other. The parents or authorized representatives wash the children's bedding weekly.
Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The Center has one outdoor play spaces, which is surrounded by a fence. The space has a cement area and a area with recycled rubber matting. LPA observed four swings and a large climbing structure approved for children ages two to five. The climbing structure and swings were anchored to the ground and were placed on the rubber matting. There is a locked shed in the outdoor play space which holds additional outdoor play equipment. Water is accessible to the children via water pitchers and cups.
Health Related Services
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
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: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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: PSD/DEL ROSA HEAD START	FACILITY NUMBER: 360911141
	VISIT DATE: 01/11/2023

NARRATIVE

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Report continued from page two

Child/Staff/Personnel Records
LPA reviewed ten child records and eight staff files. Based on LPAs review all child files were complete and contained all required information. One of eight staff files was missing LIC 501 and immunization records. LPA provided a facility representative with a technical advisory notice.

Facility Records

LPA and facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed a current roster, fire/disaster drill log (October 2022). A staff member was on site who had a current CPR/First Aid.
Posting Requirements
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393), car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist.
Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises.

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department email address unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Report continued on page four

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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: PSD/DEL ROSA HEAD START	FACILITY NUMBER: 360911141
	VISIT DATE: 01/11/2023

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Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Center shall permit the Department to inspect the child care center and to privately interview children or staff, to determine compliance with or to prevent violations of child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA provided the facility with information regarding the requirements for Lead testing in Child Care Center (PIN 22-20-CCP)

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/process
As a result of todays inspection one technical advisory notice was provided. 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 Alicia Kokinacis

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

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