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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813742
Report Date: 11/06/2025
Date Signed: 11/06/2025 12:13:09 PM

Document Has Been Signed on 11/06/2025 12:13 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:ANDERSON COUNTRY PRESCHOOLFACILITY NUMBER:
364813742
ADMINISTRATOR/
DIRECTOR:		BEVERLY ANDERSONFACILITY TYPE:
850
ADDRESS:1023 PARADISE WAYTELEPHONE:
(909) 505-7112
CITY:BIG BEAR CITYSTATE: CAZIP CODE:
92314
CAPACITY: 45TOTAL ENROLLED CHILDREN: 40CENSUS: 27DATE:
11/06/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Facility Representaitve Katie Anderson TIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On November 6, 2025 at 09:10am, Licensing Program Analyst (LPA) Zirbes met with Facility Representative Katie Anderson for the purpose of conducting an unannounced Annual/Required inspection for the preschool center. LPA toured and inspected the facility in accordance with the facility sketch. There were 27 preschool age children, and three teachers upon LPAs arrival. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The center operates out of a two story building. Only the first floor of the building is utilized for the preschool center. The preschool has three classrooms, a kitchen, two children's restrooms, and one staff bathroom. The program operates Monday thru Friday 7:00am -5:00pm
Indoor/Children's Area: Child care center was observed to be clean, 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 cabinet in the kitchen that was equipped with a child safety lock. In addition cleaning compounds were stored on high inaccessible shelf's in the classrooms. Per facility representative there are zero poisons stored within the preschool. LPA observed the indoor 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 had a variety of art supplies, blocks, and books. 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 children water bottles. All materials and surfaces are toxic free, window screens in good repair and free of debris. LPA observed a carbon monoxide detector in the Center. The carbon monoxide detector was tested during this inspection and was found to be in working order. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 11/06/2025
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Report continued from page one
Indoor/Children's Area Continued During the inspection, LPA observed two first aid kits on top of the 3-foot kitchen counter. The kitchen was accessible to one of the classrooms as a barrier was not present that prevented the children from entering the kitchen. the first aid kit contained antacid, extra strengthen non-asprin, ibuprofen, Tylenol, burn cream, neosporin. These items were labeled "keep out of reach of children". LPA did not observe the children in the kitchen during this inspection, therefore this is a potential risk and a type B citation was issued. When asked about the location of the first aid kits, the facility representative stated the kit was used yesterday, 11/5/25, and was left on the counter.
Restrooms: The Center has a total of three restrooms. Two are designated for children and one is designated for staff. Both children's restrooms had two toilets and one sink. The staff restroom had one toilet and one sink. Toilets and sinks were functioning properly and are age appropriate. Air hand dryers and soap were available to the children.
Meals: The Center provides breakfast, lunch and one snack each day. Some families choose to bring meals for their children. The kitchen was inspected and found to be sanitary and appliances were in working order. Menu was posted.
Napping: Cots are utilized for napping.
Outdoor: LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The Center has three outdoor activity spaces. At the time of this inspection only one outdoor activity space is being utilized. LPA observed a climbing structure with three slides and a tiny tikes teeter toter in the outdoor activity space. LPA observed the sand and grass placed under the teeter tooter was hard packed would not cushion a fall. LPA observed the climber with three slides was placed on sand, grass and recycled rubber. LPA observed the area around and under the high climbing equipment was hard packed at the time of this inspection and would not cushion a fall. Per LPA observation, the recycled rubber was less than 2 inches in depth. Per facility representative, the sand has become hard packed over the years and was covered with the grass material. Facility representative shared that the recycled rubber has been added however due to the weather the cushioning has not lasted. Per facility representative, prior to the children playing in the outdoor space the recycled rubber is pushed back into place around the climbing structure. Based on LPA observation the combination of hard packed sand, grass and recycled rubber observed under and surrounding the climbing equipment would not cushion a fall. A type B citation was issued for regulation 101238.2(e). Per facility representative, water is accessible to the children via individual water bottles when engaged in outdoor play. Report continued on page three
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 11/06/2025
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Report continued from page two

Outdoor: LPA observed the following in the outdoor space: plastic truck was not in good condition as the plastic was broken and had sharp edges, one side of the playskool table was not secured and bending out, the plastic door of the outdoor dramatic play kitchen was broken off and had exposed plastic edges. Based on LPA observations, the outdoor equipment was not in good condition. A Type B citation was issued.
Child/Personnel Records
LPA reviewed 10 child records and four personnel files during this inspection. Per LPA review, all records were completed and contented all required information.

Facility Records


Per records the last two emergency drills were completed in 9.3.25 and 8.11.25

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. Report continued
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 11/06/2025
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Report continued from page three

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

As a result of this inspection, three type B citations were issued

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Katie Anderson.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/06/2025 12:13 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 11/06/2025 at 11:13 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when the outdoor play equipment had sharp edges and was not in good condition, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Per facility representative, the plastic truck, the kitchen and the table will be removed from the outdoor activity space. Facility will assign a staff member to conduct weekly safety inspections of the outdoor space.
Type B
Section Cited
CCR
101226(d)
Health-Related Services
(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in when the first aide supplies were located on a three foot high kitchen counter which was accessible to the children in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Per Facility representative, the items labeled keep out of reach of children will be removed from the first aid kit. The first aid kit was relocated to an inaccessible area during this inspection.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


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Document Has Been Signed on 11/06/2025 12:13 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 11/06/2025 at 11:31 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(e)
Outdoor Activity Space
(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when the combination of hard packed sand, grass and less than two inches of recycled rubber under the high climbing equipment was not of a depth to absorb falls which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2025
Plan of Correction
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Facility Representative, will submit a plan to the Department regarding how the Center will ensure the areas under the climbing equipment are cushioned with material that absorbs falls.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Kendal Zirbes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


LIC809 (FAS) - (06/04)
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