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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364814430
Report Date: 03/11/2022
Date Signed: 03/11/2022 03:52:35 PM


Document Has Been Signed on 03/11/2022 03:52 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:PSD YUCCA VALLEY HEAD STARTFACILITY NUMBER:
364814430
ADMINISTRATOR:LUGENE SPRINGFIELDFACILITY TYPE:
850
ADDRESS:56389 PIMA TRAILTELEPHONE:
(760) 369-7424
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:48CENSUS: 15DATE:
03/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Site Supervisor Deborah Wilson TIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Zirbes met with the Site Supervisor Deborah Wilson for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the entire center, which consists of three classrooms, two children restrooms, three staff bathrooms, a family learning center, kitchen, teacher lounge, two staff offices, lobby, reception area, interview room, isolation room, outdoor play space, and four storage closets. LPA observed two classrooms in use with a total of 15 preschool children. The following staff were present: four teachers, site director and an additional staff member. The facility operates from 7:00am until 5:00pm Monday through Friday. This Head Start Program currently offers full day and half day classes.
Indoor/Children’s Area:
Child care center is 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 inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with name) for his/her clothing, personal belongings and or bedding. Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors. All materials and surfaces are toxic free. No fireplaces were present. There is a working Carbon monoxide detector, smoke detector and Fire Extinguishers (2A10BC) located in each classroom and throughout the Center. The Center had working telephone service on the premises. There is an isolation room for children who become ill while in care located near the front lobby. The facility maintains a comfortable temperature at all times. LPA observed complete first aid supplies (thermometer, bandages, scissors, ect located in each classroom and in the lobby. Sign in/out sheets were available and are completed each day. Each classroom had a water dispenser for drinking water. Report continued on page two
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD YUCCA VALLEY HEAD START
FACILITY NUMBER: 364814430
VISIT DATE: 03/11/2022
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Report continued from page one
When the children are outside drinking water is provided by an igloo water container. Smoking prohibited on the premises, daily inspection for illness is completed. LPA did not observe prohibited child care items at this time. Firearms/weapons are not allowed or stored on premises. There are no bodies of water on the premises. The Center, provides, breakfast, lunch and snack to the children. All meals are prepared in the kitchen.

Napping
Cots used are maintained in good condition. Bedding and linens were individually stored so that each child's bedding is identifiable, and no child's used bedding comes into contact with other bedding.

Restrooms
There are two children's restrooms at the Center. One of the restrooms is located between Classroom 1 and Classroom 2. This restrooms is shared by the two classrooms and consisted of one urinal, two toilets and three sinks. The second children's restroom is located with Classroom 3. This restroom, has one toilet, one urinal and two sinks. In addition, outside of the restroom in classroom 3, there is a changing table. All restrooms areas were in safe and sanitary operating condition at the time of this inspection. The children's restrooms only deliver cold water. There are three additional restrooms for the staff, parents or ill children. LPA's observed paper towel (touchless) and soap dispenser available for the children.

Outdoor
The Center has a large outdoor play area. The outdoor play area, had a shaded rest area, sand box, large climbing structure with three slides and a climbing wall, swings, tables, and additional play equipment to meet the ages of the children enrolled. The cushioning material under the play structure and swings was rubber matting. The large play structure and swings were securely anchored to the ground. The climbing structure was free from hazards, holes, broken items. A fence surrounds the outdoor area that is at least 5 feet high. No bodies of water were observed. There is a locked shed in the outdoor play space which holds additional outdoor play equipment. In addition, there is one locked closet which stores the Centers janitorial supplies.

Report continued on page three
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD YUCCA VALLEY HEAD START
FACILITY NUMBER: 364814430
VISIT DATE: 03/11/2022
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Report continued from page two

Health Related Services
A review of medication policy indicated that only prescription medication is administered and only with parent's written permission. Incidental Medical Services were discussed. At the time of this inspection, no medications are being administered or stored on the premises. If medications are required, they are stored in a locked backpacks in the classrooms. Refrigerated medications are stored in a mini refrigerator located in the teachers lounge.

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.

Staff/Personnel Records
LPA reviewed 10 child records and six staff files during this inspection. Records were complete and contained the required documentation.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed a current roster, disaster drill log, current CPR/First Aid with expiration date of 04/2023 and current mandated reporter training which expires 8/31/2023.

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393L), menu, car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist.
Report continued on page four
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD YUCCA VALLEY HEAD START
FACILITY NUMBER: 364814430
VISIT DATE: 03/11/2022
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Report continued from page three

Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. Window cords were inaccessible to children

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Director shall permit the Department to inspect the center, and to privately interview children or staff, to determine compliance with or to prevent violations of 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 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.



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.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Report continued on page five

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD YUCCA VALLEY HEAD START
FACILITY NUMBER: 364814430
VISIT DATE: 03/11/2022
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Report continued from page four

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.

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.

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 Deborah Wilson.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5