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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813742
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:18:26 PM

Document Has Been Signed on 10/30/2024 03:18 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: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: 41CENSUS: 29DATE:
10/30/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Facility Representative Katie Anderson TIME VISIT/
INSPECTION COMPLETED:
03:25 PM
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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 29 preschool age children, three teachers and an aide 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 bathrooms, one staff bathroom. The program operates Monday thru Friday 7:00am -5:30pm

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, smoke detectors and fire extinguishers located throughout the Center. Per LPA review of the first aid kit, the following items were missing: a current edition of a first-aid manual, sterile first aid dressing, tweezers, and anti septic solution. Facility representative confirmed a complete first aid kit was not on site. A type B citation was issued for regulation 101226(d), refer to LIC 809D.
Report continued on page two
Lady KingTELEPHONE: (310) 568-1824
Kendal ZirbesTELEPHONE: (661) 202-3491
DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 10/30/2024
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Report continued from page one
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. LPA did not observe the posted menu. When asked about the menu, facility representative stated, the menu for the week is usually posted on a dry erase board in the kitchen. Facility representative stated the menu had not been posted for this week. Facility Representative stated a log of the meals is kept in facility representative records. A technical advisory notice was issued.

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 was added last year. Per facility representative, prior to the children playing in the outdoor space the recycled rubber is pushed back into place around the climbing structure. LPA reviewed the Public Playground Safety Handbook. The suggested depth of recycled rubber is 6 inches. 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
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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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: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 10/30/2024
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Report continued from page two

Child/Personnel Records
LPA reviewed five child records and five personnel files during this inspection. Per LPA review, the child files were complete and contained all required documentation. Per LPA record review, two staff files (Staff 1 and staff 2) declined the influenza vaccine in 2022. The file did not contain influenza statement for 2023, LPA reminded the Center that staff shall receive an influenza vaccination between August 1 and December 1 of each year or decline the immunization each year. Per LPA review staff 3 (S3) and staff 4 (S4) did not have personnel records that contained all required information. Per review, S3 and S4 did not have documentation of their immunization's and health screening. LPA reviewed the files with the facility representative who confirmed the required information was not present in the files. Per facility representative, the staff have completed the requirements and the documentation was not added to the files. Based on LPA review of the files, one type B citation was issued for regulation 101217(a) and one technical advisory notice was issued.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. Per LPA record review of the Centers Emergency Disaster Drill Log the last drill occurred on April 3, 2024. LPA reminded the Center of the requirement to conduct emergency drills every six months. LPA advised the Center to conduct the next drill by the end of October 2024. Facility representative stated a drill occurred in October 2024 however was not documented.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. Per LPA review, the Center had documentation the water was tested January 25, 2023 by a laboratory in San Bernardino. At the time of this inspection, the Center did not have signed copies of the LIC 9275, LIC 9276 and the facility sketch with the outlets tested identified. Per conversation with facility representative Katie Anderson, a parent of an enrolled child assisted with the water sampling process. Per facility representative, the LIC 9275 and the LIC 9276 were not completed. Based on LPA review and information obtained from interviews, the facility did not have their water tested for lead in accordance to the written directives. A type B citation was issued for regulation, 101700(b), refer to LIC 809D.

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: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
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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: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742
VISIT DATE: 10/30/2024
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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/.

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, four type B citations, two technical advisory notices, one technical assistance was 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.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/30/2024 03:18 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: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700(b)
Written Directives for Lead Testing
(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above when the Center did not complete the lead testing in accordance with the written directives when the LIC 9275 and the LIC 9276 were not completed. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/06/2024
Plan of Correction
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Per facility representative, the water district and the person who completed the testing will be contacted to complete the LIC 9275 and LIC 9276. If not the Center will schedule the lead testing.
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 and interview, the licensee did not comply with the section cited above when the first aid kit was missing the current edition of a first-aid manual, sterile first aid dressing, tweezers, and anti septic solution, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/06/2024
Plan of Correction
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Per facility representative, all required items for the first aid kit will be gathered and stored in a central location. A picture and/or receipts will be submitted to the Department verifying the correction.
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: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2024
LIC809 (FAS) - (06/04)
Page: 5 of 9
Document Has Been Signed on 10/30/2024 03:18 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: ANDERSON COUNTRY PRESCHOOL
FACILITY NUMBER: 364813742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2024

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 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: 11/06/2024
Plan of Correction
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Per facility representative, the recycled rubber will be pushed back into place to see if the depth will cushion falls. Verification 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 interview and record review, the licensee did not comply with the section cited above in tow of five personnel records reviewed did not contain the required immunization and health screening, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/13/2024
Plan of Correction
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Per facility representative, the missing documentation will be obtained and added to the files. Documentation of the completed personnel records 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: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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