197750175-9-27-2023-12-CC-DMAX-CW3T3L-20230927142230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750175
Report Date: 09/27/2023
Date Signed: 09/27/2023 02:22:47 PM

Document Has Been Signed on 09/27/2023 02:22 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	A PLACE OF OUR OWN		FACILITY NUMBER:	197750175
ADMINISTRATOR:	ALLEA ADAMS		FACILITY TYPE:	830
ADDRESS:	2042 W AVENUE J		TELEPHONE:	(661) 236-3456
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 0	DATE:	09/27/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Allea Adams, Applicant/ Licensee		TIME COMPLETED:	11:59 AM

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Licensing Program Analyst (LPA) Maddox met with Allea Adams, Applicant/ Licensee today for the purpose of conducting an announced prelicensing inspection for an Infant component. The hours of operation will be: Mon through Saturday from 5:00 am am to 8:00 pm. Licensee is requesting licensure of 40 Infants ages 0 - 24 mos. Applicant/ Licensee has also submitted applications for a Preschool (197750176) and School age component (X197750177). During this inspection, LPA measured 1 classroom designated for Infants. LPA also observed a separate crib room that has a bathroom, refrigerator, and diaper changing table within arms reach of a sink. This center consist of classrooms, large industrial kitchen, bathrooms, receiving areas, Nurse Health Station, Therapy, Owners Office, Human Resources, Conference Room, Education Office, Finance Office, Enrollment Office, and the Out door play yard.

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 rooms have a surface that is safe and clean (wood flooring)
· 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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN	FACILITY NUMBER: 197750175
	VISIT DATE: 09/27/2023

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· 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 medications, food, and milk that requires refrigeration.

The center has a working telephone
Sign-in and out procedure will be done through Procare.
There is/are fully stocked first-aid kit(s) in locations accessible to staff but inaccessible to children:

· LPA observed operable carbon monoxide detectors and smoke detectors(hard wired). Fire extinguishers are located throughout the facility and fully charged.
· The center has a working telephone

The licensee shall conduct a wellness check to ensure infants with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
The indoor activity space for infants is physically separate from space used preschool children and school-age children.
The sleeping area for infants is physically separate from the indoor activity space.
LPA observed the following regarding the Infant changing tables: there is a padded surface no less than one-inch thick and covered with washable vinyl or plastic; the sides of the infant table has raised sides at least three inches high; maintained in good repair and safe condition; placed within arm's reach of a sink.
All such equipment or furniture shall be washed with a detergent/disinfectant after each use
The diaper changing table shall be washed and disinfected after each diaper change.

RESTROOMS

There is a bathroom located in each classroom, each bathroom has 1 toilet and 1 sink. All toilets and hand washing facilities shall be maintained in safe and sanitary operating condition.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN	FACILITY NUMBER: 197750175
	VISIT DATE: 09/27/2023

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Staff bathroom- there are 3 separate staff bathrooms located within the entire center.

OUTDOOR

LPA observed a shaded rest area for the children.

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. As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls (rubber matting). Drinking Water will be brought out for ?? Fenced???

· There are no bodies of water on the premises

SUPERVISION:

Sleeping infant(s) shall be directly observed by sight and sound at all times.

(A)This shall include when the infants are going to sleep, are sleeping, or are in the process of waking up.
(B)Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

Labored breathing.
Signs of distress, which includes but is not limited to flushed skin color, increase in body temperature and restlessness.
Infants up to 12 months of age who are sleeping in a position other than on their back.
If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, staff shall return the infant to their back for sleeping.

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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN	FACILITY NUMBER: 197750175
	VISIT DATE: 09/27/2023

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NAPPING

Each crib, mat or cot shall be occupied by only one infant at a time.
Bedding shall be changed daily
Cribs shall be free from all loose articles and objects, including blankets and pillows.
Pacifiers shall be allowed in the crib if the following provisions are in place: There shall not be anything attached to the pacifier.
Bumper pads shall not be used.
LPA observed Cribs, mats or cots arranged so as to provide a walkway and permit staff to reach each infant without having to step over or reach over any other infant.
LPA explained the following regarding Section 101439.1 Infant Care Center Sleeping Equipment: 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.

Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

(b) The needs and services plan shall be in writing and shall be in compliance with Title 22; Section 101419.2 including the following: Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)]. which is incorporated by reference.
The needs and services plan shall be maintained in the infant’s file and shall be available to the Department for review.

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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN	FACILITY NUMBER: 197750175
	VISIT DATE: 09/27/2023

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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.

Measurements taken were as follows:

Room #1
26 X 24.75 = 644
11.25 X 31 = 349
Total for Indoor Space Infant = 994/28
Outside play space:
20.83 X 5.08 = 106
51.67 X 33.17 = 1714/35 = 23
There is an outside play schedule that shall remain posted during the hours of operation

Fire Clearance has been received for the requested capacity of 40 children, however, with measurements taken today, center can accommodate 28 infants, there is a separate crib room that was not included in the indoor capacity.

Applicant/Licensee needs to add the new Safe Sleep information, Needs and Service plan, information regarding form LIC 9227, awaiting the rubber matting to be placed on the play yard and there needs to be outdoor shade before the license is approved.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

LIC809 (FAS) - (06/04)

Page: 6 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN	FACILITY NUMBER: 197750175
	VISIT DATE: 09/27/2023

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Drinking water is readily available - Water coolers and refrigerator with water dispenser

· 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. Stored in a locked storage room.
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. Applicant/Licensee 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

The snack menu must be posted for parents’ review

· 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.

· 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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

LIC809 (FAS) - (06/04)

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