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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364805430
Report Date: 10/10/2022
Date Signed: 10/10/2022 03:43:25 PM


Document Has Been Signed on 10/10/2022 03:43 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:MT. CALVARY KIDS CORNERFACILITY NUMBER:
364805430
ADMINISTRATOR:VICKEY ENGLANDFACILITY TYPE:
850
ADDRESS:32054 HUNSAKER WAYTELEPHONE:
(909) 867-7228
CITY:RUNNING SPRINGSSTATE: CAZIP CODE:
92382
CAPACITY:49CENSUS: 14DATE:
10/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator, Vickey England TIME COMPLETED:
12:30 PM
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On October 10, 2022, Licensing Program Analyst (LPA) Zirbes met with the Administrator Vickey England for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the facility in accordance with the facility sketch. There were 14 preschool age children and three teachers on the premises when LPA arrived. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The preschool program is operated out of three classrooms (Classroom One - 4-5 year old children, Classroom Two - 2's classroom , Classroom Three - 3's classroom). The center also operates a School Age Program (#364805431) The facility operates Monday through Friday 7:00am -6:00pm.
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 the staff bathroom which was equipped with a child safety latch. In addition, disinfecting wipes were located in high inaccessible shelves in the classrooms. Per Licensee zero poisons are stored within the preschool. LPA observed the furniture/equipment is in good condition. Classroom was 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 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 and outdoors via water bottles provided by the parents or authorized representatives. The water bottles are filled up with water from the sinks in the preschool. 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. All fire extinguishers were serviced in 2022. There are a total of three bathrooms in the Center. Classroom One had two bathrooms. One bathroom had two toilets and the other bathroom had one toilet. In addition there is another bathroom located between Classroom One and Classroom Three. This bathroom had two toilets. Hand washing sinks were located in each classroom. 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: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MT. CALVARY KIDS CORNER
FACILITY NUMBER: 364805430
VISIT DATE: 10/10/2022
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Report continued from page one
Toilets and sinks are functioning properly and are age appropriate. LPA observed 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, first aid supplies were located in each classroom. LPA observed the centers 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. At this time all food is provided by the parents or authorized representatives.
Napping
LPA observed cots for the children. LPA observed the children's blankets/sheets are stored in individual bags labeled with the children's names. The Center washes all bedding on site.
Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The Center has two outdoor play spaces. One play space is utilized for children ages two through five. The space contained a climbing structure. The climbing structure was placed on recycled rubber and was anchored to the ground. The space has a cement track for little tikes cars and had little tikes climbing equipment along with additional age appropriate outdoor play equipment. The second outdoor play space is utilized for 4-5's year olds and school age children. An approved waiver is on file. The outdoor space had a large climbing structure, dramatic play house, art supplies and sand box. The climbing structure was placed on recycled rubber and was anchored to the ground. Each of the outdoor areas were clean and free of hazards. Each of the outdoor play spaces are fully enclosed by a chain link fence. Water is accessible to the children via water bottles brought from home.
Health Related Services
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MT. CALVARY KIDS CORNER
FACILITY NUMBER: 364805430
VISIT DATE: 10/10/2022
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Child/Staff/Personnel Records
LPA reviewed 10 child records and four staff files during this inspection. One of four staff files were missing documentation of the MMR and TDAP immunization's, one of four staff files was missing documentation of the education requirement and two files were missing the mandated reporter certificates. LPA advised the Director to review staff files and ensure all required information is contained. A technical advisory notice was provided to the Center. Child files were complete.

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 with expiration date of 8/2023 and current mandated reporter training which expires 10/08/2024.
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. LPA reminded the center representative that failure to comply with posting requirements shall result in an immediate civil penalty of $100.
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 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 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 KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MT. CALVARY KIDS CORNER
FACILITY NUMBER: 364805430
VISIT DATE: 10/10/2022
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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
No deficiencies were observed during this inspection. One advisory notice was provided regarding staff files. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Administrator Vickey England.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5