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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750040
Report Date: 08/29/2023
Date Signed: 08/29/2023 10:11:34 AM

Document Has Been Signed on 08/29/2023 10:11 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:PALMDALE SCHOOL DISTRICT - DO HEAD STARTFACILITY NUMBER:
197750040
ADMINISTRATOR:DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:975 EAST AVENUE P-8TELEPHONE:
(661) 266-7864
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 12DATE:
08/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Joe Vega-SmithTIME COMPLETED:
10:30 AM
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On 8/29/2023, Licensing Program Analyst (LPA) Carol Heath met with the School Readiness Coordinator (SRC), Joe Vega-Smith, for the purpose of conducting an unannounced Annual/Random inspection. The center is located at the Head Start District Office location. The center consists of 1 room. The children start at 7:30 am to 2:30 pm. LPA disclosed the purpose of the inspection and was granted entry to the facility. Upon arrival, LPA observed 1 classroom in use with a total of 12 preschool children and 1 teacher and 1 assistant on the premises. Incidental Medical Services (IMS) were discussed.

Physical Plant: LPA toured and inspected 1 preschool classroom. Furniture and equipment were checked for age appropriateness and good repair. All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are 2 doors in the classroom. One door will be used to enter and the other to exit. Both doors have an alarm, which sounds when opened. Doors will be kept locked during center hours. There is an adjacent multipurpose/storage/office room for staff that will not be used for childcare. Doors will be kept locked during childcare hours. There are cubbies for children's belongings labeled with their names. LPA observed age-appropriate toys and materials. Daily activities schedule was observed in each classroom. LPA observed a sufficient quantity of cots available for napping children. The bedding is stored separately and properly. The sheets and blankets are washed weekly (sent home with parents to wash or staff wash after hours), and cots are sanitized daily.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2023
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 - DO HEAD START
FACILITY NUMBER: 197750040
VISIT DATE: 08/29/2023
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Drinking water is available inside the classrooms in the form of disposable plastic cups and water jugs. There is a fire extinguisher (checked 2/23/2023), a smoke detector, and a carbon monoxide detector on the premises. All containers used for storage of solid wastes, including moveable bins, shall have a tight fitting cover that is kept on; they shall be leakproof and rodent-proof.

The Center provides potty training. The staff bathroom is on the left side of the classroom. The children's bathroom is on the right side of the classroom and contains 2 toilets, 1 sink, and 1 pull-down changing table. The toilets and sinks function properly and are age-appropriate. The water temperature is appropriate. LPA observed soap, toilet paper, and paper towels readily available.

Children are inspected for illnesses as they arrive with a no-touch thermometer and an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission. The Director and other administration staff administer medication and document the dosage, date, and time on a log. Medication is brought and locked at the center (unless the parent requests daily return). Medication is labeled correctly and stored in its original container. Medication is kept at the center until the expiration date and sent home with the parent for disposal. There are currently no children in care with IMS needs. There is a separate area for isolation and care of ill children in the office. There is a mat available for ill children. An isolated toilet and sink are available for ill children in the staff restroom.

A Fire Drill/Earthquake log is posted in the office. The center conducted disaster drills every month (8/28/23). A current Roster is available.

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

DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023
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 - DO HEAD START
FACILITY NUMBER: 197750040
VISIT DATE: 08/29/2023
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The outdoor: The play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The play area was inspected and found to be free of hazards and inaccessibility to bodies of water. The jungle gym is anchored. There is a bike path, jungle gym, and other age-appropriate toys.

The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Sign-in and out sheets were reviewed. The facility uses a 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 children’s basic needs were met and appropriate.


Staff Records/ Children Records: Staff and Children's records were reviewed. LPA verified there is at least 1 staff person present with current CPR and First Aid Training. All staff complete the Mandated Reporter training every 2 years. All staff receives Measles, Pertussis, and Influenza vaccination. All staff require fingerprinting associated with the facility.
LPA reviewed 5 children's records; the records are complete with the parent’s signature.
Food Service: 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. The refrigerator will be used for medications, as well as a locked storage cabinet for other medications. The chemicals are kept separate from the food (kitchen adjacent to the kitchen sink or locked inaccessible in classroom cabinets). Menus are posted at least one week in advance and made available for review by the parents.

The following general information was discussed during this inspection:

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

DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023
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 - DO HEAD START
FACILITY NUMBER: 197750040
VISIT DATE: 08/29/2023
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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 not provide IMS at this time.
Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare 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.
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.
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: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023
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 - DO HEAD START
FACILITY NUMBER: 197750040
VISIT DATE: 08/29/2023
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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 the 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 childcare facility are aware of situations that present the greatest danger to children.
**Center Director advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation (call within 24 hours and submit a written report within 7 days) and on the form LIC624. The Center reminded to review updates/regulations as well as quarterly updates on the Department website. The "Notification of Parent's Rights" poster must be posted in an area of the center accessible to parents. The information regarding new legislation with regard to exemptions and Parent’s Rights was also discussed.

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

DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023
LIC809 (FAS) - (06/04)
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