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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911141
Report Date: 01/09/2024
Date Signed: 01/09/2024 03:59:34 PM


Document Has Been Signed on 01/09/2024 03:59 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 STARTFACILITY NUMBER:
360911141
ADMINISTRATOR:DEBBIE ARNOLDFACILITY TYPE:
850
ADDRESS:2382 DEL ROSA AVENUETELEPHONE:
(909) 883-0103
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:63CENSUS: 24DATE:
01/09/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Facility Representative Melissa RadjagukgukTIME COMPLETED:
04:10 PM
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On January 9, 2024, at 10:15 a.m., Licensing Program Analyst (LPA) Zirbes met with facility representatives, Melissa Radjagukguk. The purpose of the inspection was to conduct an unannounced required three-year inspection. LPA disclosed the purpose of the inspection to the facility representative. Present during today’s inspection were 24 preschool age children, four teachers and four additional staff members on site. The preschool program is operated out of four classrooms, six children restrooms, one staff restroom, kitchen, lobby/reception area, outdoor play space. At the time of this inspection two classrooms (60, 40) were being utilized for care. The other two classrooms were not being utilized at the time of this inspection. The facility operates from 7:30am until 4:30pm Monday through Friday. This Head Start Program currently offers an 8 hour class and a 6 hour class.
Indoor/Children’s Area:
LPA and facility representative completed a tour at approximately 11:00 a.m. 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 located in the following areas: in high inaccessible cabinets in each of the classrooms and in a high inaccessible shelf in the kitchen. At the time of this inspection, all cleaning compounds were inaccessible. Zero poisons are stored in the licensed spaced. LPA observed the furniture/equipment is in good condition. Classrooms were free of flies, other insects, rodents. The classroom had tables and chairs to meet children’s needs. LPA observed the classroom had designated areas for dramatic play, art, writing, manipulates, science, a library, computer area and a calming area. In addition, there was a carpet area for story/instructional time. 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 a water cooler and cups. All materials and surfaces are toxic free, window screens in good repair and free of debris. There is a carbon monoxide detector, smoke detector and Fire Extinguisher in the building. Report continued on page two
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 6


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: 01/09/2024
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Report continued from page one

There was working telephone service within the Center. The facility has central heating and air conditioning and was a comfortable temperature at the time of this inspection. Smoking is prohibited on the premises. LPA did not observe prohibited childcare items during this inspection. Electrical outlets are inaccessible. Firearms/weapons are not allowed or stored on premises. There are zero bodies of water on the premises. Per conversation with the facility representative, staff conduct wellness checks each day on the students. An isolation area is located in teacher desk area.
Restrooms: The Center has a total of six children's restrooms. Classroom 60 and classroom 40, have two children's restrooms located in each classroom. Each restroom was equipped with one toilet and one sink. One children restroom was located in each the other classrooms. The restrooms were equipped with one toilet and one sink. Restrooms were observed to be in safe and sanitary operating condition. Toilets and sinks are functioning properly and are age appropriate. The children's restrooms only deliver cold water. Paper towels and soap were available to the children.
Kitchen: The facility has a kitchen located in the off limits areas to the children. The kitchen was inaccessible to the children via a closed dutch door. The kitchen has a sink, refrigerator, and oven. Two meals and one snack are provided to the children. The preschool utilizes a food vendor who brings the food to the facility once a week. All food is heated and prepared in the kitchen.

Napping: Mats are utilized and were observed to be in good condition.

Outdoor: LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The Center has one outdoor play space, which is surrounded by a fence. The space has a cement area, grass area and an area with rubber surfacing. 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 surfacing. LPA observed books, trikes, trucks, and blocks in the outdoor space. 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.

Report continued on page three
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
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: 01/09/2024
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Report continued from page two
During the inspection, teacher child ratios were observed, and found to met the requirements. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.

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

Child/Personnel Records
LPA reviewed five child records and five personnel records during this inspection. Per LPAs review child records and staff records were complete. In addition, staff interviews confirmed the Administrator on record, Debbie Arnold no longer works at the Center. LPA issued the Center an advisory notice advising the Center to submit the change of Administrator/Director paperwork to the Department within the next 10 days.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed the disaster drill log (last drill completed in December 2023), sign in/out records. The Center had the required lead testing completed in 2.25.23.

Posting Requirements
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393), menu, car seat law,, emergency disaster plan.

Report continued on page four
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: 01/09/2024
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Report continued from page three

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Director shall permit the Department to inspect the center, and to privately interview children or staff, to determine compliance with or to prevent violations of 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 advised of the requirement to report Unusual Incidents. Facility representative was 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.

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.

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 LPAs record review and observations one advisory notice were issued. Refer to LIC 809D.

Report continued

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: 01/09/2024
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A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Melissa Radjagukguk.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6