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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364840739
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:59:45 PM

Document Has Been Signed on 02/19/2025 03:59 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:PSD/NORTHGATE HEAD STAR/STATE PRESCHOOLFACILITY NUMBER:
364840739
ADMINISTRATOR/
DIRECTOR:		IRMA SANTOSFACILITY TYPE:
850
ADDRESS:17251 DANTE STREETTELEPHONE:
(760) 951-1425
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 9DATE:
02/19/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:38 PM
MET WITH:Irma SantosTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On February 19, 2025, Licensing Program Analyst (LPA), Calloway conducted an unannounced case management inspection to the above facility. LPA met with the Director who granted access. LPA toured the facility with the Director and observed nine napping day care children and three staff in care.

On February 12, 2025, the Palmdale Region Office received a self-reported Unusual Incident Report (UIR) stating Child 1 opened the side gate and ran toward the parking lot. When in fact, Child 1 (C1) opened the door to their classroom and ran into the hallway. C1 opened another set of doors that led to the lobby, then ran out the main doors heading south and was in the middle of the parking lot. Staff retrieved C1 from the parking lot and brought C1 back to the facility. C1 was showing signs of distress and hitting other children. The staff knew that C1 had a history of trying to leave the classroom and the staff failed to communicate on their two-way radio for additional assistance. The three staff members inside the classroom were not able to provide supervision while addressing the outcome of C1’s behavior and did not position themselves near the doors while transitioning between activities therefore, C1 was able to open the door, avoid several staff, and run out of the building.

There is one Type A deficiency cited during this inspection for Responsibility for Providing Care and Supervision. See 809D page attached to this report.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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: PSD/NORTHGATE HEAD STAR/STATE PRESCHOOL
FACILITY NUMBER: 364840739
VISIT DATE: 02/19/2025
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Upon receipt of a Type A deficiency, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, and Appeal Rights were provided to Irma Santos, Director at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/19/2025 03:59 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 02/19/2025 at 03:45 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: PSD/NORTHGATE HEAD STAR/STATE PRESCHOOL
FACILITY NUMBER: 364840739

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/20/2025
Section Cited
CCR
101229(a)(1)

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101229 (a)(1)- Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision... the children's needs.(1) No child(ren) shall be left without ...supervision of a teacher at any time...This requirement was not met as evidenced by:
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Per Director, I will have a staff meeting with the staff addressing the break down in communication and give them copies of Active Supervision especially for children with behavioral issues. I will provide proof of the training to Licensing by the POC date.
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Based on interview, and record review Child 1 avoided several staff and ran out of their classroom and out the facility and was retrieved in the middle of the parking lot by Staff and brought back to the facility. This is an immediate health, safety, or personal rights, risks to the persons in care.
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2025


LIC809 (FAS) - (06/04)
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