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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360907170
Report Date: 01/11/2024
Date Signed: 01/11/2024 03:18:14 PM

Document Has Been Signed on 01/11/2024 03:18 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:CONCORDIA CHRISTIAN SCHOOLFACILITY NUMBER:
360907170
ADMINISTRATOR:DEBORA BARAJASFACILITY TYPE:
850
ADDRESS:420 AVENUE ETELEPHONE:
(760) 256-8979
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY: 57TOTAL ENROLLED CHILDREN: 57CENSUS: 28DATE:
01/11/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director Deborah BarajasTIME COMPLETED:
03:45 PM
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On 1/11/2024 at 11:30am, Licensing Program Analyst (LPA) Andrea Pittman arrived at the facility to conduct an Annual Random Inspection. LPA was met by Facility Representative and permitted to enter the facility. The Lead Teacher guided the LPA on a tour of the facility in accordance with the facility sketch and the Director Debora Barajas took over once she arrived at the facility. During the inspection, LPA observed 28 children and 7 staff providing care and supervision. Facility operates Monday through Friday from 6:00am to 6:00pm.

Facility consists of a total of 8 rooms/areas: two classrooms, one office, one kitchen, one staff restroom, two children’s restroom, and one outdoor play area.

Indoor Activity Space:
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and ventilation were evaluated. LPA observed sign-in sheets completed by each parent/guardian per requirements; the sign-in sheet in Classroom 2 was missing one signature, this is a Type B violation, see the LIC 809D for the details. LPA observed individual storage for children's belongings. Children are provided filtered water from a large container dispensed in individual, one-time use disposable cups. An isolation area was inspected and located in the office, near a separate restroom. The calming area was inspected and located in the corner of the classroom. Children are provided napping and age appropriate and individual bedding were observed; the facility had 42 cots available for napping. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flushed properly; toilet and sinks are reachable by the children. Each restroom has adequate toilet paper, hand soap, and paper towels available. Restrooms are cleaned, restocked with toiletries, and sanitized by on-site staff.

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SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: CONCORDIA CHRISTIAN SCHOOL
FACILITY NUMBER: 360907170
VISIT DATE: 01/11/2024
NARRATIVE
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Smoke detectors, carbon monoxide detectors, and fire extinguishers were observed and in operable condition and are operating according to Fire Marshall standards. LPA observed the first aid kit and it was found to be complete with the following supplies including tweezers, scissors, gauze, bandages, cleansing pad/solution, thermometer, and a first aid manual. Trash cans with tight lids were observed making solid wastes inaccessible to children in care. Cleaning supplies, hazardous materials, and/or poisons are found to be out of the reach of children and placed in a high cabinet, inaccessible to children in care.

Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 10/19/2023 at 9:45am for the emergency drills. The fire extinguisher (2A10BC/4A60BC) is reading in the green and meets the Fire Marshal Codes and Standards (last serviced 10/10/2023). Menus are not posted as meals are brought from home and snacks only are provided to kids. Daily activity schedules are posted showing meal/snack times and specific activities. The parent board was reviewed and has all the required forms posted accessible to parents; however, the PUB 393-Notification of Parent’s Rights had incorrect information, the facility was provided the correct PUB 393 and it was posted in all the classrooms, this is a technical violation. Food allergies are noted and are posted in the classrooms’ cabinets. There is outside food allowed as long as it is store bought, no homemade food is permitted other than the individual meals brought from home by the children.

Outdoor Activity Space:
The outdoor play area was inspected for hazards, loose, and sharp objects. At 10:04am, LPA Pittman observed there were three broken seats on a tricycle merry-go-round play equipment; LPA Pittman spoke with the Director and they made it inaccessible to children in care until they can have the play equipment fixed, this is a Type B violation, see the LIC 809D for the details. Equipment was inspected for safety, cushioning material, good repair, and age appropriateness. LPA observed climbing structures and other play equipment were found to be securely anchored with adequate, resilient, cushioning material underneath and around the perimeter. Children are provided filtered water via a large container dispensed in disposable, one-time use cups during outdoor play. There is adequate shaded area for rest. The playground is well-fenced, all around and no bodies of water were observed in the outdoor play area.

Facility maintains an adequate teacher-child ratio. Care and supervision were evaluated and determined basic needs of children are appropriate and are being met.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
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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: CONCORDIA CHRISTIAN SCHOOL
FACILITY NUMBER: 360907170
VISIT DATE: 01/11/2024
NARRATIVE
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Records/Documentation:
Children's records were reviewed for completeness. LIC 702- Preadmission Health History, LIC 700- Identification & Emergency contact, and LIC 701- Physician Reports or similar documents used by the facility; Immunization Records and CDPH 286 are all in the children's file. The LIC 613 Personal Rights Form and the LIC 995-Notification of Parent’s Rights were found in the files but had incorrect regional office address on the forms for recent enrollees dated last year (2023), this is a Technical Violation.

The facility roster was up to date and all staff have been fingerprinted and association to the designated license number. Personnel records were reviewed for completeness and found to be missing the proof of the MMR vaccine prior to starting employment for Staff 2 which is a Type B violation, see the LIC 809D for the details. Director and teachers are currently certified in Pediatric CPR/First Aid, expiring in 2024/2025. Child Care Providers (AB1207) Mandated Reporter training certificate expires in 2024/2025.

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 is violated.

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 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.

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SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
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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: CONCORDIA CHRISTIAN SCHOOL
FACILITY NUMBER: 360907170
VISIT DATE: 01/11/2024
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All staff are required to take 3-hour Child Care Provider Mandated Reporter training (AB1207) every 2 years. Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hot-line at (800) 540-4000.

For additional information and forms visit our website at: www.cdss.ca.gov



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 licensed-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.

For updates on Community Care Licensing, please visit the following website at: Childcareadvocatesprogram@dss.ca.gov



A copy of this report must be made available to the public for 3 years.

Per Title 22 Regulations, this facility is not in compliance, there are three Type B Deficiencies being cited today. Please, see the LIC 809D for the details.

Exit interview conducted and report was reviewed with the Director Debora Barajas and a copy of this Report, a Notice of Site Visit, and Appeal Rights were provided on this day.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
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Document Has Been Signed on 01/11/2024 03:18 PM - It Cannot Be Edited


Created By: Andrea Pittman On 01/11/2024 at 02:47 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: CONCORDIA CHRISTIAN SCHOOL
FACILITY NUMBER: 360907170

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not making the three broken tricycle merry go round seats inaccessible to children in care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/25/2024
Plan of Correction
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The Licensee will e-mail pictures of the repaired tricycle seats or proof that it has been made inaccessible no later than 1/25/2024.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not having proof of Staff 2 immunization against MMR prior to employment which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/25/2024
Plan of Correction
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The Licensee will e-mail the proof of immunization or proof of immunity or exemption from a physician of the MMR vaccination no later than 1/25/2024.
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: 01/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024


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Document Has Been Signed on 01/11/2024 03:18 PM - It Cannot Be Edited


Created By: Andrea Pittman On 01/11/2024 at 02:47 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: CONCORDIA CHRISTIAN SCHOOL
FACILITY NUMBER: 360907170

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(b)
Sign In and Sign Out
(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above as the LPA observed that there were 14 of the 15 signatures on the sign-in sheet for Classroom 2 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/25/2024
Plan of Correction
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The Licensee will send via e-mail a copy of the training agenda for ensuring staff has all parents sign-in and sign-out the children in care no later than 1/25/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 01/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024


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