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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364805431
Report Date: 10/10/2022
Date Signed: 10/10/2022 03:46:46 PM


Document Has Been Signed on 10/10/2022 03:46 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:
364805431
ADMINISTRATOR:VICKEY ENGLANDFACILITY TYPE:
840
ADDRESS:32054 HUNSAKER WAYTELEPHONE:
(909) 867-7228
CITY:RUNNING SPRINGSSTATE: CAZIP CODE:
92382
CAPACITY:19CENSUS: 12DATE:
10/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Vickey England TIME COMPLETED:
04:00 PM
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On October 10, 2022 at 1:00pm Licensing Program Analyst (LPA) Zirbes met with the Administrator Vickey England. The purpose of the inspection was to conduct an unannounced required one year inspection. During the inspection, LPA toured and inspected the school age program in accordance with the facility sketch. At the time of this inspection there were twelve school age children and one teacher providing supervision. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The school age area consists of one classroom, two bathrooms and a outdoor space. The center also operates a Preschool Program (#364805430). The center operates 7:00am - 6:00pm, Monday through Friday.
Indoor/Children's Area: Indoor activity space for school age children is physically separate from space used by children in the preschool component. School age center is equipped with appropriate furniture and equipment. LPA observed a dramatic play area, library, science corner, board games and art supplies. Furniture is maintained in good repair and safe condition (age appropriate). Furniture and equipment were inspected for age appropriateness and good repair. Drinking water is available inside the classroom via water bottles brought from the children's home. The water bottles are filled up utilizing the classroom sinks. Each school age child has an individual cubby labeled with their name for the storage of personal items.

Per Administrator all chemicals and cleaning materials are stored in the staff bathroom located in the preschool center. The staff bathroom door was equipped with a safety latch. Therefore the cleaning materials were inaccessible. The Center does not have a fireplace. The building has central heating. The room temperature was comfortable at the time of this inspection. LPA observed the carbon monoxide, Fire Extinguisher and smoke detector. The fire extinguisher was services in April 2022. There is a working telephone on the premises. There is an isolation room for ill children. The classroom had a first aid kit. No smoking is allowed on the premises. There are a total of two bathroom in the School age classroom. Each bathroom had one toilet and two sinks were in the classroom. The bathrooms have doors for individual privacy. 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)
Page: 1 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: 364805431
VISIT DATE: 10/10/2022
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Report continued from page one

Children are inspected for illnesses (wellness policy) as they arrive. Per Director at this time zero medications are provided to the school age children. If medications were are administered they would be provided only with parent's written permission and a doctor's note. Staff document when the medication is administered. Facility was advised that the medication must be properly labeled and stored in its original container. All medications are stored in a locked refrigerator within the staff office.

Napping: At the time of this inspection, zero school age children nap at the Center. However the children are offered the opportunity for quite time.

At the time of this inspection, snacks are provides to the school age children.

LPA observed sign in/out sheets at the entrance to the facility. Sign in and out sheets were reviewed and appeared up to date. LPA observed the staff were signing the children in and out following transportation to school.


LPA observed Licensing and Parent boards to be incompliance including the required posting. Per conversation with the Director and documentation the last disaster drill was conducted in October 2022.

File Review: 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 observed the Roster to be complete and current. The Director and additional staff have current CPR/First Aid with an expiration of 8/2023.

Posting Requirements: Center has required posting posted (license, PUB 393, LIC610, car seat law information).

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: 2 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: 364805431
VISIT DATE: 10/10/2022
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Report continued from page two

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 second outdoor play space is utilized for 4-5 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.

Food Service: There is a kitchen area used by both licensed components. At the time of this inspection snacks are provided by the Center and from home.

Transportation: The facility does not provide transportation.

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

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 licensed-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.

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: 364805431
VISIT DATE: 10/10/2022
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Report continued from page three

LPA reviewed with Administrator the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.



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. The licensee/Applicant 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 family 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.



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.

Based on LPAs observations and file review, zero citations were issued today. However one technical advisory was issued 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 Director, 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