360911538-3-1-2024-12-CC-BIBE-D2XSWF-20240301131417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360911538
Report Date: 03/01/2024
Date Signed: 03/01/2024 01:14:30 PM

Document Has Been Signed on 03/01/2024 01:14 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/HESPERIA HEAD START		FACILITY NUMBER:	360911538
ADMINISTRATOR:	HALL, PAULETTE		FACILITY TYPE:	850
ADDRESS:	9352 E AVENUE		TELEPHONE:	(760) 948-4411
CITY:	HESPERIA	STATE: CA	ZIP CODE:	92345
CAPACITY:	105	CENSUS: 28	DATE:	03/01/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	HALL PAULETTE		TIME COMPLETED:	01:40 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) Babatunde Ibitoye met with the facility Director Hall Paulette. LPA conducted a Required Annual inspection for the preschool in accordance with the facility sketch. The facility operates a full day (7:30AM-4:30PM, Monday through Friday) program (Classroom #90 and #91) and a half-day (AM hours 8:00AM-11:30AM) morning and afternoon session (PM hours 12:30PM-4:00PM Monday through Thursday). A tour of the facility was conducted. Upon arrival LPA observed five classrooms, Classroom #90 and #91 in use with a total of 28 preschool children. There were two teachers,two Aides and the Director. Incidental Medical Services (IMS) policy was discussed. Indoor/Children’s Area: Child care center is 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 inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with name) for his/her clothing, personal belongings and or bedding (stored separately). There are two portable sinks for arts and craft clean-up. Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors (Dixie cups, Sparkletts Water). All materials and surfaces are toxic free are inaccessible, no fireplace. There is a working Carbon monoxide detector, smoke detector and Fire Extinguisher (2A10BC).

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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/HESPERIA HEAD START	FACILITY NUMBER: 360911538
	VISIT DATE: 03/01/2024

NARRATIVE

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There is one bathroom for classrooms #90 and #91 (two toilets, three sinks). There are one clean bathroom (one urinal, 4 toilets, 4 sinks) for boys and girls, each are in safe and sanitary operating condition, working telephone service on the premises. Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate. if hot water (temperature 105 degrees F and 120 degrees F), hand washing fixture used by children are not required to deliver hot water. One toilet and one sink available for ill children, staff and emergency. Common towels or washcloths are prohibited.

There is an isolation area for children who become ill while in care located front office, facility maintains a comfortable temperature at all times, first aid supplies (thermometer, bandages, scissors). Sign in/out sheets available and completed daily, along with an Application System for the parent to sign-in/out (attendance). No Smoking prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Napping: LPA observed a sufficient quantity of cots available for napping children. Cots used are maintained in good condition, wiped/cleaned/disinfected (daily if needed) or when soiled, no contact with other children bedding, there is access to a safe walkway, bedding is stored separately and properly.

Outdoor: Facility has a shaded rest area; large climbing structure with cushion, free from hazard, holes, broken items, debris, dry grass; cushioning material underneath (reused tire), sandboxes free of hazardous items; six feet fence surrounding outdoor area, air conditioning equipment, water heaters, fuse boxes inaccessible. No bodies of water were observed.

Health Related Services: Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is administered only with doctor written prescription. The Director, Teacher or other administration staff administers medication and documents the dosage, date and time onto a log. Medication is brought and locked in medication bag at the center (backpack that is clearly labelled) unless parent request daily return. Medication is properly labeled and stored in its original container. Medication is kept at the center until expiration date (given to parent).

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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

FACILITY NAME: PSD/HESPERIA HEAD START	FACILITY NUMBER: 360911538
	VISIT DATE: 03/01/2024

NARRATIVE

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Medication is inaccessible to children; all prescription and non prescription medications have child’s name/photo and are dated; written consent and instruction from child’s representative; a plan to document and report to child’s representative when medication is administered to a child; IMS plan on file (if applicable).

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/childquanda.htm

Food Service/Kitchen: The kitchen area is a separate area on the premises located next to the restrooms for staff and children. The kitchen cleaning items and sharp knives are kept in a locked cabinet. Facility food is safe, stored, prepared and served in a safe manner; food preparation and storage areas are clean; dishes and utensils are clean and sanitized; menu posted one week or more in advance; snack shall include at least one serving from 2 or more of the 4 food groups. Facility serves breakfast, snack and lunch by unity meal. Food preparation area is not being used for play activities or napping; food and beverages stored in covered containers at 45 degrees or less, no food damaged containers were observed.

Staff/Personnel Records: Director is qualified, Designation of Responsibility observed, immunization's, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file.

Facility Records: Roster, disaster drill log(02/05/24) and CPR/First Aid (10/01/2024 expire) and mandated report (08/18/2024 expire) were reviewed.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty.
The following were observed posted as required: facility license ,Personal Rights (LIC613A),Parent’s Rights Poster (PUB 393L),menu,car seat law (PUB 269),emergency disaster plan, earthquake preparedness checklist.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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

FACILITY NAME: PSD/HESPERIA HEAD START	FACILITY NUMBER: 360911538
	VISIT DATE: 03/01/2024

NARRATIVE

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Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. Electrical outlets are inaccessible, no recalled and or prohibited toys or sleep/play equipment were observed on the premises. There are no window cords accessible to children.Child nap on cots.

Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.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 family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Director 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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Director shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center 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.
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.

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.

No deficiency. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am- 5pm. Exit interview conducted and report was reviewed with Director Hall Paulette .

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC809 (FAS) - (06/04)

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