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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360909087
Report Date: 11/08/2023
Date Signed: 11/08/2023 02:42:32 PM

Document Has Been Signed on 11/08/2023 02:42 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:CAROUSEL OF KIDS PRESCHOOL AND DAY CAREFACILITY NUMBER:
360909087
ADMINISTRATOR:KILMER, O./COSTA, G.FACILITY TYPE:
850
ADDRESS:24929 NATIONAL TRAILS HIGHWAYTELEPHONE:
(760) 243-2273
CITY:HELENDALESTATE: CAZIP CODE:
92342
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 16DATE:
11/08/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Licensee Olympia Kilmer TIME COMPLETED:
11:30 AM
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On 11/8/2023 at 8:05am, Licensing Program Analyst (LPA) Andrea Pittman arrived at the facility to conduct an Annual Random Inspection. LPA was met by the Licensee Olympia Kilmer and permitted to enter the facility. The Licensee guided the LPA on a tour of the facility in accordance with the facility sketch. During the inspection, LPA observed 16 children and 5 staff providing care and supervision. Facility operates Monday through Friday from 6:00am to 6:00pm.

Facility consists of a total of 10 rooms/areas: three classrooms (blue room, green room, and yellow room), one office, one kitchen, one staff restroom, three 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. LPA observed individual storage for children's belongings. Children are provided filtered water from a large container dispensed in individual water bottles. An isolation area was inspected and located in the office with a cot near a separate restroom. The calming area was inspected and located in the calm down corner in the green room. Children are provided napping and age appropriate and individual bedding were observed; the facility has cots to meet capacity requirements. 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: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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: CAROUSEL OF KIDS PRESCHOOL AND DAY CARE
FACILITY NUMBER: 360909087
VISIT DATE: 11/08/2023
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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 smoke detector tested at 8:47am and the Carbon Monoxide detector tested at 9:04am. 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, adhesive tape, 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 made inaccessible and observed to be placed on top of high cabinets in the classrooms and in the staff’s restroom for storage.

Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 9/20/2023 at 11:30am for the Fire Drill and Emergency/Earthquake Drill. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal Codes and Standards (last serviced 9/1/2023). Menus are posted at least a week in advanced and dated; however, they were not in sight of the of parents as observed by the LPA. The Licensee posted a copy of the menus on the parent board to be observed in a prominent location, this is a technical violation. Daily activity schedules are posted showing meal/snack times, nap times, and specific activities. The parent board was reviewed and has all the required forms posted accessible to parents. Food allergies are noted and are posted in the kitchen and in the classrooms. There is outside food permitted and the food is properly labeled with date and name of the child, accordingly. The center provides meals: an am and pm snack, children bring their own meals from home.

Outdoor Activity Space:
The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. 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 individual drinking bottles 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.
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SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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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: CAROUSEL OF KIDS PRESCHOOL AND DAY CARE
FACILITY NUMBER: 360909087
VISIT DATE: 11/08/2023
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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 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; Staff 1 was missing the education history in their file, this is a Type B violation, see the LIC 809D for the details. Director and teachers are currently certified in Pediatric CPR/First Aid, valid until 1/2025. Child Care Providers (AB1207) Mandated Reporter training certificate is valid until 2024 and 2025. The facility carries insurance from Great American Insurance Company, policy # PAC238192 valid until 11/7/2024.

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.

LPA discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed the facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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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: CAROUSEL OF KIDS PRESCHOOL AND DAY CARE
FACILITY NUMBER: 360909087
VISIT DATE: 11/08/2023
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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.

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, a Type B Deficiency has been cited. Please, see the LIC 809D for the details. Exit interview conducted and report was reviewed with the Licensee 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: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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Document Has Been Signed on 11/08/2023 02:42 PM - It Cannot Be Edited


Created By: Andrea Pittman On 11/08/2023 at 02:04 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: CAROUSEL OF KIDS PRESCHOOL AND DAY CARE
FACILITY NUMBER: 360909087

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(a)(6)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (6) Documentation of the educational background, training and/or experience specified in this chapter.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above by not having the educational background for Staff 1 in their personnel file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2023
Plan of Correction
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Licensee will fax the educational background/transcripts for Staff 1 no later than 11/22/2023.
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: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023


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