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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415102
Report Date: 01/12/2024
Date Signed: 01/12/2024 03:59:31 PM

Document Has Been Signed on 01/12/2024 03:59 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:CCRC HEAD START-OSBORNEFACILITY NUMBER:
197415102
ADMINISTRATOR:ANGELEE OSTERFACILITY TYPE:
850
ADDRESS:13821 OSBORNE STREETTELEPHONE:
(818) 830-1369
CITY:ARLETASTATE: CAZIP CODE:
91331
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 45DATE:
01/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Anait Ayvazyan, Center DirectorTIME COMPLETED:
04:05 PM
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On 1/12/2024 Licensing Program Analyst (LPA), Isabel Ortega met with Center Director, Anait Ayvazyan and conducted a unannounced Annual inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA observed 45 children in care and six staff providing care and supervision. Facility operates in three classrooms referred to as classroom #1, Classroom #2 and Extended care Classroom #3.

Children have the option for rest time and quiet time if needed. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, disinfects, sanitizes daily and restocked of toiletries by on-site custodian.
The furniture and equipment were inspected for age appropriateness and good repair. Blankets are provided by parents and are taken home every Friday for wash. Facility provides sheets and are washed by facility weekly. An isolation area was inspected, which takes place in the main office. Telephone service, heating, lighting, and AC ventilation were evaluated. LPA observed individual storage for children's belongings.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2024
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: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/12/2024
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Facility sampled the water for lead on 8/02/2023. Results are under the 5.5 ppb which is the maximum allowable. The classrooms consist of filtered uncontaminated water from a water dispenser. A pitcher is filled throughout the day and disposable cups are available for out and indoor water.

Facility operates Monday through Friday regular and extended CSPP State Program. Regular program is Monday through Friday from 7:30 a.m. to 3:30 p.m. and Extended CSPP State Program (classroom#3) Monday through Friday from 7:30 a.m. to 5:30 p.m. Facility provides breakfast, lunch and after-school snack for children enrolled and for the extended care classroom two snacks are provided.

Facility has all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, and Earthquake Preparedness Checklist.

First Aid supplies, smoke detectors, carbon monoxide are observed to be operating properly. The fire extinguisher (2A10BC) is reading in green (last serviced on 8/22/2023) and meets the Fire Marshal codes and standards.

Trash cans with tight lids were observed. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. A refrigerator is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 12/15/2023 at 10:00 a.m. Food allergies are noted(Bee aware sign)and are posted in the food preparation area and in each classroom.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
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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: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/12/2024
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The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair, and age appropriateness. During outdoor play children are provided with filtered water in a water pitcher container (disposable cups are available). There is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed in the outdoor play area.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

Facility has staff in each classroom currently certified in Pediatric CPR/First Aid which does not expire until 01/05/2026. Child Care Provider Mandated Reporter (AB1207) training is dated 08/18/2023.

The following Incidental Medical Services (IMS) were discussed.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and 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.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
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: CCRC HEAD START-OSBORNE
FACILITY NUMBER: 197415102
VISIT DATE: 01/12/2024
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The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301, (800) 514-0383

All staff are required to take the Child Care Provider Mandated Reporter (AB1207) training every 2 years. www.mandatedreporterca.com. Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations. Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hot-line at (800) 540-4000. For additional information and forms visit our website at: www.cdss.ca.gov For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov https://ccld.childcarevideos.org/

Per Title 22 Regulations facility is complying with rules and regulation, no deficiency will be issued today. An exit Interview was conducted with Center Director, Anait Ayvazyan. A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

A copy of this report must be made available to the public for 3 years. and the Notice of Site Visit shall be posted for 30 days from inspection.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC809 (FAS) - (06/04)
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