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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813646
Report Date: 01/04/2023
Date Signed: 01/04/2023 04:03:57 PM


Document Has Been Signed on 01/04/2023 04:03 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:VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCAREFACILITY NUMBER:
364813646
ADMINISTRATOR:LISA BALDWINFACILITY TYPE:
850
ADDRESS:59025 YUCCA TRAILTELEPHONE:
(760) 365-9049
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:60CENSUS: 36DATE:
01/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:37 AM
MET WITH:Administrator Lisa Baldwin TIME COMPLETED:
04:15 PM
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On January 4, 2023, Licensing Program Analyst (LPA) Zirbes met with the Administrator Lisa Baldwin 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 36 preschool age children, five teachers, one teacher aide, the administrator and two additional staff members on site. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The preschool program is operated out of four classrooms (Classroom C - 3-4 year old children, Classroom B1 - Pre- K, Classroom B2 - 2-3 year old children, Classroom B3 - Pre K). The center is located on Valley Community Chapel Campus. The center also operates a School Age Program (364818052). The facility operates Monday through Friday 6:00am -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 key locked cabinet in each classroom. Per Licensee 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 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 bottles provided by the parents/authorized representatives and water coolers/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 three bathrooms in the preschool Center. Classroom C had one bathroom with one sink and one toilet. Classroom B2 had a diaper changing area along with two bathrooms with a total of three toilets, one urinal and three sinks. The children in classroom B1, B2, and B3 utilize the bathrooms in B2. 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: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
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: VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCARE
FACILITY NUMBER: 364813646
VISIT DATE: 01/04/2023
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Report continued from page one Toilets and sinks were 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. 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 three snacks a day and the authorized representatives provide the children with lunch. All snacks are stored in refrigerators within the classroom.
Napping
LPA observed cots for the children. LPA observed the children's blankets/sheets are stored in a manner that 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 three outdoor play spaces. All outdoor spaces are enclosed by a chain link fence. One space was located near Classroom C and was identified as a mud kitchen. The second play space had two climbing structures. The climbing structures were placed on recycled rubber and were anchored to the ground. During the inspection, LPA advised the Administrator to ensure the octagon climber had a fall zone that met the manufactures requirements. The third play space has sand box area, cement and space for the children to utilize the trikes and bikes. LPA observed the Center has hula hoops, balls and a variety of outdoor play equipment. An approved waiver is on file allowing for the school age and preschool components to share playground space and co-mingle from 6-7am and 5-6pm. Water is accessible to the children via drinking fountain and water coolers 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 KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023
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: VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCARE
FACILITY NUMBER: 364813646
VISIT DATE: 01/04/2023
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Report continued from page two

Child/Staff/Personnel Records
LPA reviewed 10 child records. All child records included all required information. LPA reviewed a total of six staff files. Based on LPA's review, Staff 2 and Staff 3 did not have current mandated reporter training. S3 has been employed since 6/10/22 and has not completed the course. S2s mandated reporter training expired 1/20/19. A Type B citation was issued for Health and Safety Code, 1596.8662(b)(1), as this poses a potential risk to the children in care. In addition based on LPAs review, Staff 1 (S1) file was missing documentation of S1 educational background training or experience that qualified S1 as a fully qualified teacher. S3 file was missing documentation that S3 was currently enrolled in continuing education courses to meet the requirements of a teacher. S3 files was also missing documentation of immunization's (MMR, TDAP, TB) and LIC 503 health screening report. A type B citation was issued for regulation, 101217(a) as this poses a potential risk to the children in care.

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 (September 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 on the website: 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: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCARE
FACILITY NUMBER: 364813646
VISIT DATE: 01/04/2023
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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 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
Two type B deficiencies were observed during this inspection. LPA also provided the Center with two advisory notices. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Administrator Lisa Baldwin,
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 01/04/2023 04:03 PM - It Cannot Be Edited

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: VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCARE
FACILITY NUMBER: 364813646

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in two out of six staff files. Staff 2 (S2) and Staff 3 (S3) did not have current mandated reporter training. S3 has been employed since 6/10/22 and has not completed the course. S2s mandated reporter training expired 1/20/22. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2023
Plan of Correction
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Per Administrator S2 and S3 will complete the mandated reporter training. A copy of the training certificates will be submitted to the Department.
Type B
Section Cited
CCR
101217(a)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above when two of six staff files were not complete. Staff 1 (S1) file was missing documentation of S1 educational background training or experience that qualified S1 as a fully qualified teacher. S3s file was missing documentation that S3 was currently enrolled in continuing education courses to meet the requirements of a teacher. S3 file was also missing documentation of immunization's (MMR, TDAP, TB) and LIC 503 health screening report. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/01/2023
Plan of Correction
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Per Administrator, all staff files will be reviewed to ensure all required documents are in the staff files. Copies of the missing items will be submitted to the Department.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
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