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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815293
Report Date: 01/25/2023
Date Signed: 01/25/2023 03:13:17 PM


Document Has Been Signed on 01/25/2023 03:13 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:CSUSB-INFANT/TODDLER CENTERFACILITY NUMBER:
364815293
ADMINISTRATOR:DEANNA HERNDONFACILITY TYPE:
830
ADDRESS:5500 UNIVERSITY PARKWAYTELEPHONE:
(909) 537-5661
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:30CENSUS: DATE:
01/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Heather Moon, Asst. DirectorTIME COMPLETED:
03:28 PM
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Licensing Program Analyst (LPA), Maddox met with Heather Moon, Asst. Director today for the purpose of conducting an unannounced Required 1 year inspection . The Infant/Toddler component operates in the Social and Behavioral Sciences Bldg and occupies the following classrooms: #132, 143, & 147 Center also has a licensed Pre-school (360906559 - in a separate building) and School-age component (360909152), Center adheres to the physical separation of each component. There is a current roster available and at least 1 staff member present with current CPR and First Aid training (exp. 10/24). Days and Hours of operation: Mon - Thursday from 7:30 am - 5:30, on Fridays center closes at 5:00 pm.

INDOOR ACTIVITY SPACE:
  • The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors
  • Floors of all classrooms have a surface that is safe and clean (wood flooring and carpet)
  • A comfortable temperature for children was maintained.
  • Furniture and equipment were observed to be in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023
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: CSUSB-INFANT/TODDLER CENTER
FACILITY NUMBER: 364815293
VISIT DATE: 01/25/2023
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  • Tables and chairs were present to meet the needs of the children.
  • Drinking water is readily available water cooler
  • Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children (stored in high cabinets and child locks).
  • There are fully stocked first-aid kit(s), fire extinguishers and carbon monoxide detectors in all classrooms (in locations accessible to staff but inaccessible to children).
  • The isolation is located in the office for any child who becomes ill during the day.
  • The center has a working telephone
  • Center uses a manual Sign-in and out procedure
  • Staff conducts wellness checks on children as they arrive and throughout the day to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
  • Infant equipment and furniture is washed with a detergent/disinfectant after each use
OUTDOOR

LPA observed adequate shade and rest area for the children, there are 2 separate play yards (Infant and Toddler Yard). LPA observed rubber matting and age appropriate play equipment. Drinking water will be brought out for children. The Infant/Toddler yards are surrounded by fencing. The play yard was free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

· There are no bodies of water on the premises


SUPERVISION:

Teacher child ratio's were observed and in compliance with Title 22 Regulations.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
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: CSUSB-INFANT/TODDLER CENTER
FACILITY NUMBER: 364815293
VISIT DATE: 01/25/2023
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RESTROOMS

All toilets and hand washing facilities were maintained in safe and sanitary operating condition. LPA observed a changing table within arms reach of a sink in each classroom.

Staff bathrooms are located in the hallways and will be used as isolation bathrooms.

CHILDREN’S RECORDS:


LPA reviewed random children's records and all files contained required forms including newly implemented Safe Sleep requirements.
NAPPING
  • Cots and cribs are used for napping
  • Each cot/mat shall be equipped with a sheet to cover the crib or cot
  • Bedding/Linen is stored in cubbies which are labeled with each child's name.
  • Cribs were free from all loose articles and objects, including blankets and pillows.
  • There were no objects hanging above or attached to the side of the crib.
  • Staff document a physically check on Infants every 15 minutes (documentation observed).
  • Documentation were maintained in the infant’s file and be available for review.
  • Staff has incorporated an Individual Infant Sleeping Plan [LIC 9227 and Needs and Service Plan for each Infant (0 - 12 months)
HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children.

A refrigerator shall be used to store any medication that requires refrigeration.

Director has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
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: CSUSB-INFANT/TODDLER CENTER
FACILITY NUMBER: 364815293
VISIT DATE: 01/25/2023
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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

FOOD SERVICES

Parents provide lunches for Infant/Toddlers

· Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies.


· Trashcans had tight fitting covers
· There is a refrigerator available to store any medication that requires refrigeration.

POSTINGS:

LPA observed the required forms that are required to be posted. There is a disaster and mass casualty plan in place.

Asst Director is aware of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.



Exit interview was conducted. This report was read, and a copy provided to Heather Moon, Asst. Director.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
LIC809 (FAS) - (06/04)
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