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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409079
Report Date: 04/18/2023
Date Signed: 04/18/2023 03:26:12 PM

Document Has Been Signed on 04/18/2023 03:26 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:PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD STARTFACILITY NUMBER:
197409079
ADMINISTRATOR:DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:1100 EAST AVENUE R-4TELEPHONE:
(661) 267-9934
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 200TOTAL ENROLLED CHILDREN: 200CENSUS: 154DATE:
04/18/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:Joe Vega-Smith TIME COMPLETED:
03:45 PM
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On 4/18/2023, Licensing Program Analyst (LPA) Carol Heath met with the School Readiness Coordinator (SRC), Joe Vega-Smith, and the Education Coordinator, Elizabeth Mora, for the purpose of conducting an unannounced Annual/Random inspection. This Head Start Program is held on the grounds of Tumbleweed Elementary School. LPA disclosed the purpose of the inspection and was granted entry. LPA toured and inspected the preschool in accordance with the facility sketch. The Center is fenced and separated from the campus of Tumbleweed Elementary School. LPA toured classrooms #1 through #10. The classrooms are operating Monday through Thursday from 7:30 am to 3:45 pm and will cater to children ages 3 yrs to 5 yrs. Children will nap on cots; bedding and linens will be stored in cubbies; Breakfast, lunches and snack will be delivered from the cafeteria. Upon arrival, LPA observed 10 classrooms in use with a total of 154 preschool children and 10 teachers and 10 teacher assistants on the premises. Incidental Medical Services (IMS) were discussed.

LPA toured and inspected the 10 classrooms. Furniture and equipment were inspected for age appropriateness and good repair. The Center provides potty training. There were no changing tables present; Joe Vega-Smith mentioned that diaper changing is done standing.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD START
FACILITY NUMBER: 197409079
VISIT DATE: 04/18/2023
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LPA observed a sufficient quantity of cots available for napping children. 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. The sheets and blankets are washed weekly (sent home with parents to wash or staff washes after hours), and cots are sanitized daily.

The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. There is a large play structure securely anchored with padded floor underneath for cushioning and a shaded area for rest. The area was observed to be free of debris. Drinking water is available in the form of a water pitcher and disposable cups. Play area was inspected for hazards and inaccessibility to bodies of water.

The telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings in each classroom. LPA observed age-appropriate toys and materials. Drinking water is available inside the classroom in the form of a water pitcher and disposable cups. There are fire alarms and carbon monoxide detectors located by the doors of each classroom. Fire extinguishers are maintained properly. There is a Fire Drill/Earthquake log posted and a current Roster available.

The facility's menu is posted in the room. Meals are brought by the district daily. The facility serves breakfast, lunch, and snacks. Allergy lists are posted in the office. LPA observed an appropriate amount of food and snacks.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD START
FACILITY NUMBER: 197409079
VISIT DATE: 04/18/2023
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The refrigerator will be used for medications as well as a locked storage cabinet for other medications. LPA observed an appropriate amount of food and snacks. Cleaning solutions and other chemicals are kept in a cabinet above the sink with the lock-in classroom and the main building's maintenance room.
Children's restrooms are located inside each classroom has two sinks and two toilets. The toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper, and paper towels readily available. The staff restroom is located in the adjacent building across from the play yard near the parking lot. There is a sink in each classroom that's used for food preparation. LPA observed available drinking water inside each classroom in the form of a water cooler and disposable cups.
The parent board was reviewed and has all the required forms posted. Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily. Medication is properly labeled and stored in its original container. There are currently children in care with IMS needs. There is a separate area for the isolation and care of ill children in each classroom. There is a mat available for ill children.
Sign-in and out sheets were reviewed. The facility uses digital sign-in sheet. The Teacher to child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if the basic needs of children were met and appropriate. LPA observed a parent board consisting of licensing-required postings. Fire/earthquake drills current.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD START
FACILITY NUMBER: 197409079
VISIT DATE: 04/18/2023
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Children's records and staff records were reviewed. LPA reviewed 10 children’s files with completed information. LPA verified there is at least 1 staff person present with current CPR and First Aid Training. There are 2 teachers and 1 aide in each classroom. At least 1 staff person in each classroom present has current CPR and First Aid training: 3/24. All staff completed their Mandated Reporter training every 2 years.
The following general information was discussed during this inspection:
The 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does provide IMS at this time.

Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, child care providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. Staff was informed that they need to take mandated reporter training.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD START
FACILITY NUMBER: 197409079
VISIT DATE: 04/18/2023
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Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Safe Sleep Information: California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state licensed facility to another using form LIC 9184

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PALMDALE SCHOOL DISTRICT-TUMBLEWEED HEAD START
FACILITY NUMBER: 197409079
VISIT DATE: 04/18/2023
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**Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of the report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt. Staff is aware of required forms for children's files and forms that shall be posted after licensure.

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements


Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.
**Parent Board contained all documents that are required to be posted according to Title 22 Regulations. Staff is certified in Pediatric CPR and First Aid. Sign-in and out sheets were inspected and contained full legal signatures. There is a fully stocked first aid kit available and a fully charged fire extinguisher and carbon monoxide detectors in place. Fire Drill/Earthquake log is posted.

No deficiencies are being cited at this time, the facility complies with Title 22

Exit interview conducted with Director. A copy of this report is discussed and left with School Readiness Coordinator Joe Vega-Smith and the Education Coordinator, Elizabeth Mora.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
LIC809 (FAS) - (06/04)
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