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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750170
Report Date: 02/01/2024
Date Signed: 02/01/2024 02:25:07 PM

Document Has Been Signed on 02/01/2024 02:25 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:
197750170
ADMINISTRATOR:BEATRIZ ZAMORANO-PEDREGONFACILITY TYPE:
850
ADDRESS:44236 10TH ST WESTTELEPHONE:
(661) 494-7999
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 25DATE:
02/01/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:52 AM
MET WITH:Supervisor Leah SottoTIME COMPLETED:
02:35 PM
NARRATIVE
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On 2/1/2024 at 9:52am, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced case management visit at the facility and was met by Family Advocate Evelia Flores and later joined by the Supervisor Leah Sotto at 10:50am. LPA completed a tour of the facility while waiting on the Supervisor to arrive, according to the facility sketch. Upon arrival, LPA observed 25 children with 6 staff members providing care and supervision.

During this inspection, LPA received pertinent documents related to this inspection which included the facility’s staff and children’s rosters, personnel records, and other relevant documents. At 9:52am, LPA Pittman arrived at the facility and was met by the Family Advocate. LPA Pittman asked if the Director or Lead was available. The Family Advocate admitted that there was no one on site that could assist me as the Supervisor of the day was off-site at the Palmdale location. The Family Advocate called the Supervisor to have them come and assist at the center. LPA Pittman spoke with the Supervisor over the phone, at that time, and asked of their knowledge of the regulation that a director or lead be present on site at all times during operational hours. The Supervisor stated that they were aware but had to go to another site to onboard a new hire and the Lancaster center was without a director as the two directors "were recently let go." Once the Supervisor arrived at the Lancaster Center at 10:50am, LPA Pittman explained the Title 22 regulation to the Supervisor and provided technical assistance of the regulation and staff members that could act as lead when the Supervisor is not present on site. This is a Type B Violation, see the LIC 809D for the details.

As a result of the inspection, the facility was found to be in noncompliance with Title 22 Regulations and has been cited one Type B deficiency, see the LIC 809D for the details.

All licensing reports are recommended to be kept for 3 years.

An exit interview was conducted, and a copy of this report was read and provided to the Supervisor along with the Notice of Site Visit and Appeal Rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2024
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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Document Has Been Signed on 02/01/2024 02:25 PM - It Cannot Be Edited


Created By: Andrea Pittman On 02/01/2024 at 12:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: CCRC 10TH STREET HEAD START
FACILITY NUMBER: 197750170

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/15/2024
Section Cited
CCR
101215.1(d)

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101215.1 Child Care Center Directors Qualifications and Duties (d) The child care center director, or the substitute director... shall be on the premises during the hours the center is in operation.
This requirement was not met as evidenced by:
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Licensee will submit via e-mail a written plan of Director coverage until the director has been replaced no later than 2/15/2024.
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Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above as the LPA observed there was no director, or substitute, during operational hours which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Andrea Pittman
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024


LIC809 (FAS) - (06/04)
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