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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364806901
Report Date: 11/30/2022
Date Signed: 11/30/2022 03:08:43 PM

Document Has Been Signed on 11/30/2022 03:08 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:SBCUSD-MUSCOY ELEMENTARY SCHOOLFACILITY NUMBER:
364806901
ADMINISTRATOR:DELIA CASTANEDAFACILITY TYPE:
850
ADDRESS:2119 W. BLAKETELEPHONE:
(909) 730-3674
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 3DATE:
11/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Patricia AyalaTIME COMPLETED:
03:23 PM
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Licensing Program Analyst (LPA) Maddox met with Lead Teacher, Patricia Ayala today for the purpose of conducting an unannounced Annual/Random inspection. Present today were 3 children and 3 staff persons. This Preschool program is held on the grounds of Muscoy Elementary School and occupies 1 classroom, there are 2 half day sessions. The hours of operation: MONDAY THROUGH FRIDAY 8:15 A.M.- 11:15 A.M. AND 12:15 P.M.TO 3:15 P.M. This preschool closes for the summer months and commences in August

**LPA observed age appropriate furniture, equipment, toys and materials. The classroom was observed to be clean and safe and free of any Health or safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the wall as you enter classrooms. Drinking water is available inside the classroom in the form of a water fountain.

**The children's bathrooms are located within the classroom, there are 2 bathrooms with 1 toilet and 1 sink in each. The staff rest-room is located in the classroom as well. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2022
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: SBCUSD-MUSCOY ELEMENTARY SCHOOL
FACILITY NUMBER: 364806901
VISIT DATE: 11/30/2022
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All flooring and carpets were inspected for cleanliness, and good repair. Children do not nap, center serves snacks only (menus posted).

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material. Equipment and climbing structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available in the form of a water fountain. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area.

**The Parent Board located within the classrooms has contains required licensing forms. Staff are certified in Pediatric CPR and First Aid (exp 6/2023).



*Center utilizes an electronic sign in and out system, a hard copy can be printed out by District Office. LPA observed a fully stocked first aid kit; fully charged fire extinguishers; and carbon monoxide detectors. Fire Drill/Earthquake log is posted.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: SBCUSD-MUSCOY ELEMENTARY SCHOOL
FACILITY NUMBER: 364806901
VISIT DATE: 11/30/2022
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Meals are provided through the school cafeteria, LPA observed menu's posted in the classroom.

LPA reviewed files of children present, all files were complete and contained required documentation, staff files are kept at the District office. Staff are fingerprinted through the San Bernardino School District, Teachers credentials are verified (Teacher's and Site Supervisor permits posted).


There were no violations noted as a result of this inspection, Center is operating in accordance to Title 22 Regulations. Exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC809 (FAS) - (06/04)
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