360902919-9-29-2022-12-CC-KZIS-CJQRA6-20220929125038

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360902919
Report Date: 09/29/2022
Date Signed: 09/29/2022 12:51:43 PM

Document Has Been Signed on 09/29/2022 12:51 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:	PSD/SAN BERNARDINO PARK & REC HEAD START		FACILITY NUMBER:	360902919
ADMINISTRATOR:	LISA SIMMONS		FACILITY TYPE:	850
ADDRESS:	2969 FLORES STREET		TELEPHONE:	(909) 887-3349
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92405
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	09/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Teacher, Nelly Munoz-Rios		TIME COMPLETED:	01:10 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	Licensing Program Analyst (LPA) Zirbes met with the Nelly Munoz-Rios, Facility Representative for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the facility in accordance with the facility sketch. There were 10 preschool age children, two teachers, an aide, site supervisor and additional staff on the premises when LPA arrived. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The preschool program is operated out of two classrooms (60,1, 50) out of San Bernardino Parks and Recreation Building. At the time of this inspection only classroom 60 was being used. Classroom 1 and 50 sustained physical plant damage and is not being used until all repairs are complete. LPA advised the Center to notify CCL when classroom becomes operational. The facility currently operates Monday thru Friday 7:00am -4:30pm Indoor/Children's Area: Child care center was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in a janitors closet located in the community building. LPA observed the furniture/equipment is in good condition. Classroom was free of flies, other insects, rodents. The classroom had tables and chairs to meet children’s needs. LPA observed the classroom had designated areas for writing, dramatic play, art, reading, and a computer area. In addition, there was a carpet area for story time/instructional area. Children's belongings are kept in cubbies labeled with the children's names. Trash cans for solid waste have tight fitting lids. Drinking water is readily available indoors via cups and a water dispenser. All materials and surfaces are toxic free, window screens in good repair and free of debris. There is a working Carbon monoxide detector, smoke detector and Fire Extinguishers which met the State Fire Marshals standards. There are two bathrooms located within the classroom each equipped with a toilet and sink. Bathrooms were equipped with stalls for individual privacy. Bathrooms were observed to be in safe and sanitary operating condition. Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Report continued on page two

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

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: PSD/SAN BERNARDINO PARK & REC HEAD START	FACILITY NUMBER: 360902919
	VISIT DATE: 09/29/2022

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Report continued from page one
There was working telephone service within the classroom. There is an isolation area for children who become ill. The isolation area is located within the office. The facility maintains a comfortable temperature at all times, first aid supplies were located in the classroom. LPA observed the centers electronic sign in/out sheets, which are completed daily. Smoking is prohibited on the premises. LPA did not observe prohibited childcare items during this inspection.
Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises. Meals are provided through the San Bernardino County Food Program.
Napping
LPA observed each child had an individual mat, all linens were stored individually. The classroom has a designated areas for relaxation and quite play.
Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The area has one large play structure, tricycles, balls, chalk, outdoor area was equipped with shade. The large play structure had two slides. Rubber cushioning material was present under the play structure and the play structure was securely anchored to the ground. Water is available outdoors via a pitcher and cups brought out with the teacher.

Health Related Services
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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
If medications are required, they are stored in the nurses office.
Facility Records

LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility.

LPA observed a current roster, disaster drill log.
Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC809 (FAS) - (06/04)

Page: 5 of 7

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: PSD/SAN BERNARDINO PARK & REC HEAD START	FACILITY NUMBER: 360902919
	VISIT DATE: 09/29/2022

NARRATIVE

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Report continued from page two

Staff/Personnel Records
LPA reviewed nine child records and six staff files during this inspection. Based on LPAs review, one out of nine child files reviewed was missing a medical assessment within 30 days of enrollment. Child was enrolled on 8/22/22. LPA provided a technical violation notice for regulation 101220(a) Child Records. Based on LPAs staff file review the records were complete. During the inspection LPA was advised that the Administrator on file Lisa Simmons no longer works at the Center. LPA advised the Center to submit the required documentation to the Department so the Administrator can be updated. LPA provided a technical violation notice for regulation 101212(b) Reporting Requirements.

Posting Requirements

The following were observed posted as required: facility license, Parent’s Rights Poster (PUB 393), car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist. LPA observed the posted menu was for August 2022. Staff reported the new food service company had not provided the menus for the month of September. Center reported they have requested the menus from the company on multiple occasions. LPA advised the Center to obtain and post menus as required. LPA reminded the facility representative that failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. .

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Center shall permit the Department to inspect the child care center and to privately interview children or staff, to determine compliance with or to prevent violations of child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Report continued on page four

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: PSD/SAN BERNARDINO PARK & REC HEAD START	FACILITY NUMBER: 360902919
	VISIT DATE: 09/29/2022

NARRATIVE

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Report continued from page three

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

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 license 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Based on LPA record review zero citations were issued today however LPA provided the Center with technical violation notices regarding Child Records, Reporting Requirements and Food Service.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Nelly Munoz-Rios.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC809 (FAS) - (06/04)

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