<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750148
Report Date: 01/03/2024
Date Signed: 01/03/2024 04:54:08 PM


Document Has Been Signed on 01/03/2024 04:54 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 10TH STREET HEAD STARTFACILITY NUMBER:
197750148
ADMINISTRATOR:BEATRIZ ZAMORANO-PEDREGONFACILITY TYPE:
830
ADDRESS:44236 10TH STREET WESTTELEPHONE:
(661) 494-7999
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:54CENSUS: 0DATE:
01/03/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Director Lizet TIME COMPLETED:
05:15 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 1/3/2024 at 9:05am, Licensing Program Analyst (LPA) Andrea Pittman arrived at the facility to conduct an Annual Random Inspection. LPA was met by the Facility Representative and permitted to enter the facility. The Director Liset Doyle and Donald Bakeer guided the LPA on a tour of the facility in accordance with the facility sketch. During the inspection, LPA observed 0 children and 9 staff ready to provide care and supervision. Facility operates Monday through Friday from 7:30am to 5:30pm.

Facility consists of a total of 20 rooms/areas: six classrooms, two offices, one kitchen/breakroom, three staff restroom, six children’s restroom, and two outdoor play area (one infant area separated from the toddler area.)

Indoor Activity Space:
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed sign-in sheets used by the facility via an application Learning Genie and also paper sheets in the classrooms that are completed by each parent/guardian, per the requirements. LPA observed individual storage for children's belongings. Children are provided filtered water from a large container dispensed in individual, one-time use disposable cups. An isolation area was inspected in the director’s offices and located near a separate staff restroom for separation from healthy children. The calming area was inspected and located in the far corner of the classrooms. Children are provided napping and age appropriate and individual cribs and mats for older children and children who could climb out of cribs were observed. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flushed properly; toilet and sinks are reachable by the children. Each restroom has adequate toilet paper, hand soap, and paper towels available. Restrooms are cleaned, restocked with toiletries, and sanitized by on-site staff.

Continue to next page

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5


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 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/03/2024
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
26
27
28
29
30
31
32
Smoke and carbon monoxide detectors were observed and in operable condition and are operating according to Fire Marshall standards; the detector was tested at 9:39am. LPA observed the first aid kit and it was found to be complete with the following supplies including tweezers, scissors, gauze, bandages, adhesive tape, cleansing pad/solution, thermometer, and a first aid manual. Trash cans with tight lids were observed making solid wastes inaccessible to children in care. Cleaning supplies, hazardous materials, and/or poisons are found to be out of the reach of children and locked under the sink in each classroom.

Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 12/5/2023 at 3:30pm and 10/19/2023 at 10:30am for the Fire Drill and Emergency/Earthquake Drill, respectively. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal Codes and Standards (last serviced 7/12/2023). Menus are posted at least a week in advanced, dated, and in sight of parents to review. Daily activity schedules are posted showing meal/snack times, nap times, and specific activities. The parent board was reviewed and has all the required forms posted and accessible to parents. Food allergies are noted and are posted in the kitchen and in the classrooms in a folder labeled “Bee Aware.” There is no outside food allowed. The center provides meals: breakfast, lunch, and one snack.

Outdoor Activity Space:
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. LPA observed climbing structures and other play equipment were found to be securely anchored with adequate, resilient, cushioning material underneath and around the perimeter. Children are provided filtered water via a large container dispensed in disposable, one-time use cups during outdoor play. There is adequate shaded area for rest. The playground is well-fenced, all around and no bodies of water were observed in the outdoor play area.

Facility maintains an adequate teacher-child ratio. Care and supervision were evaluated and determined basic needs of children are appropriate and are being met.

Continued to next page
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/03/2024
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
26
27
28
29
30
31
32
Records/Documentation:
Children's records were reviewed for completeness. LIC 702- Preadmission Health History, LIC 700- Identification & Emergency contact, and LIC 701- Physician Reports or similar documents used by the facility; Immunization Records and CDPH 286 are all in the children's file. The LIC 9227- Individual Infant Sleeping Plan was not found in the records of three of the infants enrolled under 12 months of age; per the Director, the documents were once in the files but misplaced and they no longer have the records on file. This is a technical violation; the Director was provided a copy of the form to include in all future applications.

The facility roster was up to date and all staff have been fingerprinted and association to the designated license number. Personnel records were reviewed for completeness. Director and teachers are currently certified in Pediatric CPR/First Aid, expiring in 2024-2025. Child Care Providers (AB1207) Mandated Reporter training certificate is expiring in 2024-2025. Staff 1 was missing an infant course, the staff was provided an exception for the missing course until May 2024 the expected completion of the course.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



Continue to next page
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/03/2024
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
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care
Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a


consumer education website that helps families obtain child care by connecting them to child
care providers and Resource and Referral Agencies (R&Rs) throughout California.

All staff are required to take 3-hour Child Care Provider Mandated Reporter training (AB1207) every 2 years. 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. Applicants must meet requirements as a precondition to licensure. 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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


For updates on Community Care Licensing, please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/03/2024
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
26
27
28
29
30
31
32
A copy of this report must be made available to the public for 3 years.

Per Title 22 Regulations, this facility is in compliance, no deficiency will be issued today. Exit interview conducted and report was reviewed with the Director Donald Bakeer and a copy of this Report, a Notice of Site Visit, and Appeal Rights were provided on this day.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5