197416078-2-27-2024-12-CC-JDMO-D2V27R-20240227160910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416078
Report Date: 02/27/2024
Date Signed: 02/27/2024 04:09:26 PM

Document Has Been Signed on 02/27/2024 04:09 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:	LANCASTER-JACK NORTHROP ELEMENTARY STATE PRESCHOOL		FACILITY NUMBER:	197416078
ADMINISTRATOR:	FOUNTAIN, KELLY		FACILITY TYPE:	850
ADDRESS:	835 EAST AVENUE K-4		TELEPHONE:	(661) 948-6152
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 22	CENSUS: 20	DATE:	02/27/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:			TIME COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 02/27/2024, at 9:35 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the Lead Teacher, Erica Robinson (staff 1) to conduct an unannounced One Year Required inspection for the preschool license in accordance with the facility sketch. A tour of the facility was conducted. LPA observed a total of 20 preschool children in one classroom (Room 20) with 3 staff providing care and supervision. The center has two sessions The center has two sessions and operates Monday through Friday, from 8:00 A.M. - 11:00 A.M. for the first session, and 12:30 P.M. to 3:30 P.M. for the second session. Indoor/Children’s Area: The room is clean, safe, sanitary and in good repair; the entrance and exit doors of the classroom is kept free of obstructions; floors of the room have a surface that is safe and clean, spray bottles disinfectants are used to sanitize rooms, furniture/equipment is in good condition and is free of flies, other insects, and 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 storage space (cubby, individually labelled with name) for his/her clothing, personal belongings. There is a working telephone. Electrical outlets are inaccessible and has plastic safety plugs. Recalled and or prohibited toys or sleep/play equipment were not observed on the premises. There are no window cords accessible to children. Trash bins for solid waste have tight fitting lids. Per staff 1, they have maintenance and cleaning personnel that comes after the afternoon session. Water dispenser is available in the classroom. Children used small plastic cups/container to pour water into disposable paper cups. All materials and surfaces are toxic free and are inaccessible. There is no fireplace in the facility. The center has an internal pull-down fire alarm system and fire extinguishers with a 2-A:10-B:C classification and the last service date was on 07/15/2023 (reading in green, checked at 10:15 A.M.). Carbon monoxide devices are in operable condition (tested at 11:09 A.M.). Restrooms: LPA inspected and observed one toilet and one sink inside the classroom. LPA observed liquid

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

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: LANCASTER-JACK NORTHROP ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197416078
	VISIT DATE: 02/27/2024

NARRATIVE

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soap, paper towel, toilet paper, and height measuring equipment. Water temperature is appropriate. There is an isolation area for children who become ill while in care and children sit on little couches. Children who are ill are also accompanied by the staff and were taken to the Nurse Office. The facility maintains a comfortable temperature at all times, first aid supplies (first aid manual/guide, bandages, scissors, tweezers), electronic sign in/out sheets available and completed daily. Smoking is prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Per staff 1, children do not nap inside the classroom. No sleeping mats/cots were observed during this inspection.

Outdoor: The facility has one playground area for the preschool children. 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. Drinking water is provided using water jug. Play equipment has rubber cushioning material. No bodies of water were observed.

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: According to staff 1, the lead teacher is the designated personnel to administer only prescription medications with the parents’ consent and document the dosages, date, and the time the medications were administered.

Staff 1 stated that they were not providing transportation to children in care.

Children are inspected for illnesses (wellness policy) as they arrive. Teachers visually check and observed children when they arrive at the facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

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: LANCASTER-JACK NORTHROP ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197416078
	VISIT DATE: 02/27/2024

NARRATIVE

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provided, a Plan for Providing 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 Service: The facility has monthly menu posted on the parent board. The center provides breakfast for the morning session and lunch for the afternoon session.

Staff/Personnel Records: Designation of Responsibility observed, immunization's, TB clearance (for staff 1 and 2), health screening, criminal record statement, statement acknowledging requirement to report suspected child abuse, CPR/First Aid trainings were completed on 09/20/2022 and 05/12/2022, and mandated reporter were reviewed and observed on file with dates completed on 07/16/2023 and 08/15/2023.

Facility Records: Electronic Roster, fire/disaster drills log was completed last 02/22/2022 at 1:55 P.M.

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 394), emergency disaster plan, earthquake preparedness checklist, and California Car Seat Law.

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

Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available.

According to staff 1, parents use electronic Sign in and out sheets when dropping off and picking up their child The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. The facility has a daily schedule posted inside the classroom.

Director was 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

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: LANCASTER-JACK NORTHROP ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197416078
	VISIT DATE: 02/27/2024

NARRATIVE

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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 family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

No deficiencies were cited during this inspection.

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. The On 8Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Exit interview conducted and a copy of this report, Notice of Site Visit, and appeal rights were provided to Lead Teacher Erica Robinson.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

LIC809 (FAS) - (06/04)

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