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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750148
Report Date: 01/20/2023
Date Signed: 01/20/2023 03:40:11 PM

Document Has Been Signed on 01/20/2023 03:40 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: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 0DATE:
01/20/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH: Angelee Oster, Early Learning Supervisor TIME COMPLETED:
02:05 PM
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Licensing Program Analyst's (LPAs) Maddox met with Angelee Oster, Early Learning Supervisor for the purpose of conducting a Pre-Licensing inspection for a Infant/Toddler component. This center is located within a strip mall. The tour included Office space, Kitchen, the indoor and outdoor areas, bathrooms, conference room, and 6 classrooms. Days/hours of operation will be Monday through Friday from 7:30 am - 5:30 pm.

INDOOR ACTIVITY SPACE:

  • The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors
  • Floors of all classrooms have a surface that is safe and clean (wood flooring and carpet)
  • A comfortable temperature for children shall always be maintained.
  • Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
  • Tables and chairs were present to meet the needs of the children.
  • Drinking water is readily available water cooler
  • Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children (stored in high cabinets.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/20/2023
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  • There are fully stocked first-aid kit(s), fire extinguishers and carbon monoxide detectors in all classrooms (in locations accessible to staff but inaccessible to children).
  • The isolation is located in the office for any child who becomes ill during the day.
  • The center has a working telephone
  • Sign-in and out procedure -----
  • The licensee shall conduct a wellness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
  • All such equipment or furniture shall be washed with a detergent/disinfectant after each use
OUTDOOR

The outdoor area is accessible through classroom #4 and the hallway. LPA observed adequate shade and rest area for the children, there are 2 separate play yards (Infant and Toddler Yard). LPA observed rubber matting and age appropriate play equipment. Drinking water will be brought out for children. The yards are surrounded by wrought iron fencing. The play yard was free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

· There are no bodies of water on the premises


RESTROOMS

Each classroom has it's own bathroom, each bathroom has 2 toilets and 3 sinks. All toilets and hand washing facilities were maintained in safe and sanitary operating condition. LPA observed a changing table within arms reach of a sink in each classroom.

Staff bathrooms are located in the hallways and will be used as isolation bathrooms.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/20/2023
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SUPERVISION:

Director shall ensure no child is left without the direct supervision of a teacher at any time, Supervision shall include visual observation.

CHILDREN’S RECORDS:


LPA explained all children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours.
NAPPING
  • Cots and cribs will used for napping
  • Each cot/mat shall be equipped with a sheet to cover the crib or cot
  • LPA informed Director Cots or mats should be wiped with a detergent/disinfectant weekly or when soiled or wet.
  • Bedding/Linen will be stored in cubbies.
  • Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
  • Mattresses shall be made specifically for the size crib in which they are placed.
  • Cribs shall be free from all loose articles and objects, including blankets and pillows. There shall not be anything attached to the pacifier. There shall not be anything attached to the pacifier.
  • There shall be no objects hanging above or attached to the side of the crib.
  • Staff shall physically check on the infant every 15 minutes and check for labored breathing. Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.
  • Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
a. Date.
b. Infant’s name.
c. Time of each 15-minute check.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/20/2023
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Individual Infant Sleeping Plan [LIC 9227 and Needs and Service Plan shall be completed for each Infant (0 - 12 months)
HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children.

A refrigerator shall be used to store any medication that requires refrigeration.

Director has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

FOOD SERVICES

· Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies.


· Lunches will be delivered from the Central Kitchen located in Van Nuys, center will also provide formula for Infants. Food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.
· Trashcans, including moveable bins, shall have a tight fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.
· There is a refrigerator available to store any medication that requires refrigeration.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/20/2023
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POSTINGS:

The Applicant/Licensee was informed of the required forms that shall be posted after licensure including the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5

Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.

Applicant is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.


Each classroom has a front and back area:
Room #1 (18 - 36 mos)
FT -12.8 X 19.6 = 251
Rear - 24.2 X 27.8 = 673
Total = 924 minus 1.76 (cabinet) = 922/35 = 26

Room #2 (0 - 2 yrs)
Ft 15.5 X 16.10 = 250
Rear 22.7 X 22 = 499
Total = 749 minus 1.76 (cabinet) = 747/35 = 22

Room #3 (0 - 2 yrs)
Ft 24 X 12.5 = 300
Rear 30 X 32 = 960
Total 1035 minus 1.76 (cabinet) 1035 minus crib area 225 = 810/35 = 23

Room #4 (18 - 36 mos)
Ft 12.5 X 21 = 275
Rear 28.2 X 30 = 846
Total = 1121 minus 1.76 (cabinet) = 1119/35 = 31
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750148
VISIT DATE: 01/20/2023
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Room #5 (18 - 36 mos)
Ft 12.5 X 22 = 275
Rear 22 X 31 = 682
Total 957 minus 1.76 (cabinet) = 955/35 = 27

Room #6 (18 - 36 mos)
Ft 12.5 X 20 = 250
22 X 31 = 682
Total 932 minus 1.76 (cabinet) = 930/35 = 27

Bathroom:
2 toilets and 2 sinks in each classroom: 30 X 6 = 180

Outside play space:
Infant Yard: 28 X 42.6 = 1193/75 = 16
Toddler Yard: 98 X 19.3 = 1891/75 = 25


The outside play schedule shall remain posted during the hours of operation

Fire Clearance has been received for the requested capacity of 54 children.

LPA provided consultation on the following:
Reporting Requirements/Unusual Incidents
CCL Website- Provider Information Notices (PIN's)
Required Postings
Forms for Children’s files
Forms for Staff files

Center Preschool is ready for licensure. Exit interview was conducted. This report was read, and a copy provided to Angelee Oster, Early Learning Supervisor

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
LIC809 (FAS) - (06/04)
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