360906559-1-17-2025-12-CC-KZIS-DD22DG-20250117161819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360906559
Report Date: 01/17/2025
Date Signed: 01/17/2025 04:18:36 PM

Document Has Been Signed on 01/17/2025 04:18 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:	CSUSB CHILDREN'S CENTER		FACILITY NUMBER:	360906559
ADMINISTRATOR/ DIRECTOR:	ALEXANDRIA CHUNG		FACILITY TYPE:	850
ADDRESS:	5500 UNIVERSITY PARKWAY		TELEPHONE:	(909) 537-5928
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92407
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 50	CENSUS: 16	DATE:	01/17/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:31 AM
MET WITH:	Administraror Alexandria Chung		TIME VISIT/ INSPECTION COMPLETED:	04:25 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 and Cha met with Administrator Alexandria Chung for the purpose of conducting an unannounced Annual/Required inspection for the preschool center. LPAs toured and inspected the facility in accordance with the facility sketch. There were 16 preschool age children, seven teachers, two interns, two support staff and the administrator in site. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. Physical Plant: The preschool program is located on CSUSB campus. The program is consists of two classrooms (Yotes - 3 -4 year old children and Pups 2.5 to 3 year olds), two restrooms, one staff restroom, a staff break room, administrative office, laundry/storage area, kitchen, outdoor activity space. The facility operates Monday through Thursday 7:00am - 5:30pm, Friday 7:00am - 5:00pm. Center is closed when CSUSB classes are not in session. Indoor/Children's Area: Child care center was observed to be clean, 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 in spray bottles located on inaccessible hooks in the classrooms. Cleaning products were also stored in a cabinet under the kitchen sink, in the laundry room and at the front desk on a high inaccessible shelf. Per facility representative there are zero poisons stored within the preschool. LPA observed the indoor furniture/equipment was in good condition. Classroom was free of flies, other insects and rodents. The classrooms had tables and chairs to meet the children's needs. LPA observed the Center had a variety of art supplies, dramatic play equipment, blocks, and books. 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 individual water bottles which are filled from the drinking fountain in classroom. All materials and surfaces are toxic free, window screens in good repair and free of debris. There was a working carbon monoxide detector located in the kitchen. The Center has smoke detectors and fire extinguishers located throughout the Center. Report continued on page two

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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: CSUSB CHILDREN'S CENTER	FACILITY NUMBER: 360906559
	VISIT DATE: 01/17/2025

NARRATIVE

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Report continued from page one
Restrooms: The Center has two children restrooms, located in each classroom. Each of the restrooms had two toilet and one sink. Toilets and sinks were functioning properly and were age appropriate at the time of this inspection. Paper towels and soap were available to the children. A diaper changing area was present within the pups classroom. Additional sinks were located in the classrooms. In addition, there is one staff restroom on site.

Meals: The Center provides breakfast, lunch and one snack. Menus were posted in the front entranceway and in the kitchen.

Napping: Mats are utilized for napping.

Outdoor: LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The Center has two outdoor play spaces. One play space consisted of a large grass area. The second space has a climbing structure placed on rubber tiles, a play house, sand boxes, tables and chairs and additional materials and activities for the children. LPA observed caution tape on the stairs of one of the entrances to the play structure. Per Administrator the rubber coating on the stairs was starting to crack therefore the caution tape was added as a safety precaution. Per Administrator a staff member is stationed at this entrance to assist the children. LPA observed the rubber tiles surrounding the climbing structure were lifting up on the corners and were showing signs of wear. Administrator stated the Center is currently in the process of accepting bids to have the cushioning material under the climbing structures replaced along with the rubber coating on the stairs. During the walk through LPAs observed a wooden table in the play space that had chipped blue paint and the wooden surface was rough to the touch. LPA advised the Administrator to have the table sanded and repainted. During this inspection, the table was removed.

Child/Personnel Records
LPA reviewed nine child records and six personnel files during this inspection. Per LPAs review all child files were complete and contained all required information.

Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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: CSUSB CHILDREN'S CENTER	FACILITY NUMBER: 360906559
	VISIT DATE: 01/17/2025

NARRATIVE

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Report continued fro page two
File review continued:
During a walk through of the Center, LPAs observed staff 1 (S1) in the kitchen preparing meals. LPA reviewed the staff associations for the Center and observed S1 was not listed as having obtained an eligible clearance. Per Administrator and the facility LIC 500, S1 has worked at the Center since November 2024. According to the Administrator, S1 primary role is preparing meals and shopping. Per Administrator and the LIC 500 S1s job title is Nutrition Assistant, work schedule is Fridays from 7:30-1:30pm. LPAs and Administrator discussed S1 background clearance. Administrator expressed S1 background clearance has not appeared in Guardian yet, however S1 has fingerprinted twice. LPA completed a reviewed of the Departments background clearance system at approximately 11:14am. The Department records revealed S1's background is in process. During the inspection, the Administrator did not provide LPA with documentation showing S1 had a eligible California background clearance. Based on record review, interviews, and observation, S1 is an employee who has been working at the Center since November 2024. S1 did not received a California clearance prior to working at the Center. A type A citation was issued for regulation, 1596.871(c)(1)(A), as this poses a immediate risk to the children in care. Refer to LIC 809D.
Facility Records
LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21-CCP.

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.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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: CSUSB CHILDREN'S CENTER	FACILITY NUMBER: 360906559
	VISIT DATE: 01/17/2025

NARRATIVE

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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 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 s violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

As a result of this inspection, one type A citation was issued.
LPA Zirbes, informed Administrator Alexandria Chung that this report dated 1/17/25, document(s) one Type A citation which shall be posted for 30 consecutive days as there are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Zirbes informed the licensee to provide a copy of this licensing report dated 1/17/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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 Alexandria Chung.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/17/2025 04:18 PM - It Cannot Be Edited

Created By: Kendal Zirbes On 01/17/2025 at 03:16 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: CSUSB CHILDREN'S CENTER	FACILITY NUMBER: 360906559
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above when Staff 1 did not obtain a criminal record clearance prior to initial presence in the facility, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 01/17/2025
	Plan of Correction
1 2 3 4	Per Administrator, S1 was removed from the site today 1.17.25. S1 will not return until a criminal records clearance has been obtained. The facility will ensure that all staff have a criminal record clearance prior to initial presence in the facility. Administrator will notify the Department when S1 has received an eligible clearance.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Lady King

LICENSING EVALUATOR NAME:

Kendal Zirbes

LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC809 (FAS) - (06/04)

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