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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360909152
Report Date: 06/01/2023
Date Signed: 06/01/2023 02:46:56 PM


Document Has Been Signed on 06/01/2023 02:46 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 CENTERFACILITY NUMBER:
360909152
ADMINISTRATOR:DEANNA HERNDONFACILITY TYPE:
840
ADDRESS:5500 UNIVERSITY PARKWAYTELEPHONE:
(909) 537-5928
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:16CENSUS: 0DATE:
06/01/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:09 PM
MET WITH:Director, Deanna Herndon and Asst. Director, Heather Moon TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Deanna Herndon and Asst. Director, Heather Moon today for the purpose of conducting a Case Management inspection. Director is requesting to temporarily relocate the School-age (SA) component from the main building to another building on campus due to spacing (the Yasuda Building in Room# 109). The SA component operates during the summer months only (from June to August). Days and Hours of Operation are Mon - Thurs from 7:00 am to 5:30 pm.

SA children will share the play yard with the PS children and also utilize a large grass area in front of the Yasuda building. Due to the layout of the campus, SA children will be dropped of in front of the main building and escorted by staff to the SA classroom. Also, children shall be escorted to the bathrooms (The 2 bathrooms are located within the building but around the corner from the classroom). LPA observed age appropriate materials and play equipment. Drinking water is available via Sparkletts water cooler. A fire clearance has been received and approved for the relocation, the relocation is approved as a result of this inspection. Exit interview conducted, a copy of this report was reviewed and signed by Asst. Director, Heather Moon.


SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:
DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/01/2023
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CSUSB CHILDREN'S CENTER
FACILITY NUMBER: 360909152
VISIT DATE: 06/01/2023
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The following measurements were taken today in Room #109:
Front Triangle area:
22 X 20 = 440/2 = 220/35 = 6
Back Area:
20 X 20.5 = 410/35 = 12
Total Indoor Space: 18

Bathrooms
Boys bathroom has 5 stalls, 3 urinals and 6 sinks
Girls bathroom has 6 stalls and 6 sinks

A fire clearance has been received and approved for the relocation, the relocation is approved as a result of this inspection. Exit interview conducted, a copy of this report was reviewed and signed by Asst. Director, Heather Moon.


SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
LIC809 (FAS) - (06/04)
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