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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191290795
Report Date: 04/11/2024
Date Signed: 04/11/2024 03:12:07 PM

Document Has Been Signed on 04/11/2024 03:12 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:YMCA OF METRO LA/SANTA CLARITA VALLEY MEADOWSFACILITY NUMBER:
191290795
ADMINISTRATOR/
DIRECTOR:		NATALIE GALSTYANFACILITY TYPE:
840
ADDRESS:25577 FEDALA ROADTELEPHONE:
(310) 486-2870
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: 55DATE:
04/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Site Supervisor Kyle Mitchell TIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On April 11, 2024, Licensing Program Analyst (LPA) Alemoh met with site supervisor Kyle Mitchell for the One Year Required inspection. A tour of the facility was conducted. Upon arrival LPA observed 4 classrooms in use (4 classrooms total) with a total of 55 school age children. There were 7 staff on the premises along with the site supervisor. The hours of operation are 7:00AM - 7:30AM Monday - Friday and after school hours are Monday - Thursday 1:45PM - 6PM and Friday 12PM- 6PM. Incidental Medical Services (IMS) were discussed.

There are no pools or bodies of water on the premises.
There are a total of 4 classrooms: Pathfinder Rm, Discovery Rm, Explore Rm, and Adventure Rm.

Indoor/Children’s Area: Child care center is clean, safe, sanitary and in good repair; all indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of the classroom has a surface that is safe and clean, cleaning compounds inaccessible(locked in a cabinet), 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 storage space (baskets, individually labelled with name) for his/her clothing, and personal belongings.

Trash cans for solid waste have tight fitting lids and children bring drinking water bottles, as well as reusable cups and water is also provided by the facility. All materials and surfaces are toxic free are inaccessible and there is no fireplace. There are working carbon monoxide detectors, smoke detectors and Fire Extinguishers (3A40BC x2) in each classroom. There is a working land line telephone on the premises.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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: YMCA OF METRO LA/SANTA CLARITA VALLEY MEADOWS
FACILITY NUMBER: 191290795
VISIT DATE: 04/11/2024
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Restrooms: LPA inspected and observed 4 restrooms for children. Each restroom has 1 toilet and 1 sink, however each classroom has a sink for children to wash hands. LPA observed soap, toilet paper and paper towels readily available in all restrooms. Water temperature is appropriate.

Outdoor: Children use the open grass area behind the classrooms. Cones are place markers for children not to go out of bounds. Children use the outdoor play equipment was inspected for health, safety, good repair and age appropriateness. The area was observed to be free of debris, free from hazard, holes, broken items, debris, No bodies of water were observed. There are areas for shade and rest.


Staff/Personnel Records: Designation of Responsibility observed, immunization's, TB clearance, mandated reporter training's, Director qualifications, health screening, criminal record statement, and statement acknowledging suspected child abuse are digitally stored and unavailable for review.

Facility Records: Roster, fire/disaster drill log last completed on 03/15/2024(fire drill). CPR/First Aid and mandated report training were reviewed and maintained current. M.R expires on 02/12/2026. CPR expires on 08/2024.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394L), emergency disaster plan, earthquake preparedness checklist.

Food Service: Sharp utensils, open bottles or alcohol are inaccessible. The facility has a clean and fully stocked refrigerator/freezer. This is an after school program and only snacks are provided.

Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

Advisory/Other: First aid supplies (thermometer, bandages, scissors) readily available in the classroom. There is an isolation area for children who become ill while in care located in the classroom, facility maintains a comfortable temperature at all times, sign in/out sheets available and completed daily. Smoking is prohibited on the premises, and daily inspection for illness is conducted. Firearms/weapons are not allowed or stored on premises.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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: YMCA OF METRO LA/SANTA CLARITA VALLEY MEADOWS
FACILITY NUMBER: 191290795
VISIT DATE: 04/11/2024
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Electrical outlets are inaccessible, recalled and or prohibited toys or sleep/play equipment were observed on the premises. There are no window cords accessible to children.

Sign in and out sheets were reviewed. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Roster current.

Teacher child ratios were observed and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.



Health Related Services: Director is advised all prescription and non-prescription medications must have child’s name and are dated, written consent and instruction from child’s representative, and a plan to document and report to child’s representative when medication is administered to a child; IMS plan was discussed and Director understands when IMS is necessary.

Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is administered only with parent's written permission (licensing medication form- LIC9221 - also used). Per Director, she does not have children enrolled who require medication. LPA advised the Director must administer medication, and document the dosage, date and time onto a log. Medication can be brought and taken home by the parent daily. Medication will be properly labeled and stored in its original container. There is a separate area for isolation and care of ill children in the director’s office.

Currently, Incidental Medical Services are provided to children in care. LPA reviewed 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/childquanda.html
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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: YMCA OF METRO LA/SANTA CLARITA VALLEY MEADOWS
FACILITY NUMBER: 191290795
VISIT DATE: 04/11/2024
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Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B 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 the day care center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiency was cited today.

Exit interview conducted and report was reviewed with the Director. This report was read and provided to along with her appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
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