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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407723
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:17:35 AM

Document Has Been Signed on 09/10/2024 11:17 AM - 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 ECE PALM TREE CENTERFACILITY NUMBER:
197407723
ADMINISTRATOR/
DIRECTOR:
DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:326 EAST AVENUE RTELEPHONE:
(661) 265-1744
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 30DATE:
09/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:32 AM
MET WITH:Lisa Fowler, Assistant AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 09/10/24, Licensing Program Analyst (LPA) Justeene Tamayo met with Assistant Administrator, Lisa Fowler, who granted access to the facility. The purpose of the inspection was to conduct an unannounced case management inspection for a UIR received at Palmdale RO on 09/05/24. LPA disclosed the purpose of the inspection. Upon arrival, there are 30 preschool children in care, along with 4 Lead Teachers , 3 Assistant Teachers, and 1 Noon Duty teacher.

Description of Incident: On 09/05/24, classroom staff unintentionally served muffins from the elementary school cafeteria that were found to be moldy. Mold spots were visible on the muffins in both classrooms (A and B). Some children had already started eating the muffins when the issue was discovered. The muffins were immediately discarded upon discovery.

During the subsequent inspection, LPA Tamayo interviewed the involved staff and conducted a walk through of the elementary school cafeteria. It was determined that the muffins had an expiration date of 09/24, meaning they were not expired at the time they were given to the preschool children.

The facility notified parents via Learning Genie, the Palmdale School District, and the Child Nutrition Department. The Child Nutrition Department is working with the elementary school cafeteria to prevent a recurrence of this issue. There have been no reports of illness among the preschool children as a result of consuming the muffins.



This incident was deemed accidental. No deficiencies were cited at this time.

An exit interview was conducted, a copy of this report was provided to Assistant Administrator Lisa Fowler, along with her appeal rights and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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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