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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844264
Report Date: 06/28/2022
Date Signed: 06/28/2022 06:46:17 PM

Document Has Been Signed on 06/28/2022 06:46 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:READY SET GROW LEARNING SERVICESFACILITY NUMBER:
364844264
ADMINISTRATOR:LILAMANIE SENEWIRATNEFACILITY TYPE:
830
ADDRESS:1528 PUMALO STREETTELEPHONE:
(909) 883-6628
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 11TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
06/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Facility Representative Angie Bustillos TIME COMPLETED:
06:45 PM
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On June 28, 2022 at 9:15am Licensing Program Analyst (LPA) Zirbes met with the Office Administrator Angie Bustillos. The purpose of the inspection was to conduct an unannounced required one year inspection. During the inspection, LPA toured and inspected the Infant program in accordance with the facility sketch. LPA observed a total of six infants, and one teacher and one aide providing supervision at the time of the inspection. The infant area consists of one classroom, one sleeping area, changing area, and an outdoor space. The center also operates an School Age Program (#364844265) and Preschool Program (#364844266). The center operates 6:30am-6:00pm, Monday through Friday.
Indoor/Children's Area: Indoor activity space for infants is physically separate from space used by children in the preschool and school-age child care center components. Infant center is equipped with appropriate furniture and equipment, changing table and feeding chairs. Furniture is maintained in good repair and safe condition (age appropriate). LPA did not observe sharp points or edges, or small parts that could be swallowed. Per staff equipment, toys and furniture are sanitized daily. There is one hand washing sink within arms length of the changing table. No infant is left without supervision (visual), nor left unattended. At the time of this inspection, the facility was in compliance with the staff/infant ratio and is not exceeding the approved capacity for the facility.
Furniture and equipment were inspected for age appropriateness and good repair. LPA observed vinyl blocks on the shelving units in the infant room, had tears along the edges and corners of the materials. In addition LPA observed the molding at the base of the wall was ripped and had a sharp edge exposed. Based on LPAs observations the toys and part of the play space were not in good repair at the time of this inspection. Refer to LIC 809D for further information regarding the citation. LPA observed exposed screw head on the back side of a shelving unit and advised the center to cover the screw heads. LPA observed staff with infants during lunch and nap time. There is a Infant Daily Report in the classroom which the staff complete daily. Used diapers are put in a diaper genie which is stored near the changing area. Each infant has container labeled with their name for the storage of personal items. There was one evacuation crib in the sleeping room. Report continued on page two
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264
VISIT DATE: 06/28/2022
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LPA observed the cleaning compounds were stored on a high shelf above the sink. Additional cleaning products for the Center are located in two locked storage closets equipped with a key lock. The infant center does not have a fire place however there is a inaccessible fireplace located within the school age area. The building has central heating and air conditioning units were secured in the windows of the Center. The room temperature was comfortable at the time of this inspection. LPA observed the carbon monoxide, Fire Extinguisher and smoke detector in working condition. There is a working telephone on the premises. There is an isolation room for ill children. The first aid kit within the infant classroom was inspected and based on LPA observation, the first aid kit was missing a current edition of a first-aid manual. Since a complete first aid kit was not available a citation was issued, refer to LIC 809D. LPA observed sign in/out sheets at the entrance to the facility. Per attendance records Child 1 was at the Center five days in June (1,2, 17, 20, 27). The sign in and out sheets for all five days did not have the time that C1 was signed into the Center. Furthermore, on June 17 and 20 the sign in and out was missing the signature of the person who signed C1 into care. Based on the record review the attendance records are not being maintained per regulation, 101229.1(a)(1), refer to LIC 809d. No smoking is allowed on the premises. LPA did not observe baby walkers or other prohibited play equipment on the premises.

Children/Infant are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription and non prescription medication are administered only with parent's written permission and a doctor's note. Staff document when the medication is administered. Facility was advised that the medication must be properly labeled and stored in its original container. All medications are stored in an inaccessible container in the front office.

Napping: LPA observed cribs and cots in the infant area. Per staff, children over one years of age are transitioned to a cot on the floor. Currently the Center is utilizing three cribs. The crib mattress were covered in a cloth material not a vinyl or similar moisture-resistent material, as required., refer to LIC 809D for information regarding the citation.



Report Continued on page three
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264
VISIT DATE: 06/28/2022
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Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.

At this time, the only outside food brought into the Center is milk other than vitamin D, formula, and parents provide all food for children under one. LPA observed the outside food and milk was dated and labeled with the child's name.

Infant File Review: LPA reviewed a total of 10 infant files. Eight of ten infant files reviewed were missing a medical assessment of the child preformed a licensed physician. Nine of ten infant Needs and Services Plans were not signed by the Center and were completed by the Parent. Furthermore, Four out of the ten infant files reviewed did not have the Needs and Service Plans updated quarterly as required. Four of the ten infant files reviewed were missing an individual Infant Sleeping Plan for children under 12 months of age.
Refer to LIC 809D for information regarding the issued citations.



LPA observed Licensing and Parent boards to be incompliance including the required posting. Per conversation with the facility representative, and record review the last disaster drill was conducted in October 2020. Therefore the disaster drills are not being conducted every six months as required, the facility was issued a type B citation. Refer to LIC 809D.

Staff Files: LPA reviewed a total of six staff files, four of six staff files reviewed were missing documentation that the employee had received or declined the influenza vaccination between August 1 and December 1 of 2021. In addition, two of six files reviewed did not have documentation that the mandated reporter training had been renewed within two years as required. Two type B citation were issued, refer to LIC 809D.

Facility Records: LPA observed the Roster to be complete and current. The Administrator and additional staff have current CPR/First Aid with an expiration of 10/24

Posting Requirements: Center has required posting posted (license, PUB 393, LIC610, car seat law information).

LPA verified the Center has telephone service during the inspection.
Report continued on page four
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264
VISIT DATE: 06/28/2022
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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
Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The licensee/Applicant shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Based on LPA observations and file review, citations were issued during the inspection today regarding incomplete staff and child files, and physical space. Refer to LIC 809D for further information.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Angie Bustillos.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
Page: 5 of 15
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264
VISIT DATE: 06/28/2022
NARRATIVE
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Outdoor: Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. The outdoor play area has an enclosed specific area for the infants. LPA observed the soft mats which were previously secured to the concrete were not secured at the time of this inspection. Mats were observed upside down with the glue exposed and scattered around the outdoor activity area, the mats posed a potential tripping hazard to the infants in care. The sand in the outdoor activity area had five piles of animal feces. Based on LPA observation the area was not inspected daily and kept free of hazardous material. LPA also conducted a complete tour of the licensed outdoor space. LPA observed, a box of nails was on the ground, construction materials, empty beer bottles, empty water bottles, used facial masks, and additional trash was throughout the licensed space. Furthermore there were 6 inch plants growing in licensed space.
Type B citation were issued since the outdoor play area was not being utilized due to excessive heat warning today.
Food Service: There is a kitchen area used by all three licenses. Based on LPA observation today, the food was prepared and served in a safe manner. The Center is on the food program and provides all meals and snacks. Menus were posted in the lobby and kitchen. Allergy lists are posted in kitchen. LPA observed an appropriate amount of food and snacks for infants during the inspection.
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.

LPA reviewed with Administrator the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.


LPA discussed the safe sleep regulations with Administrator and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Administrator 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.
Report continued on page five
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
Page: 4 of 15
Document Has Been Signed on 06/28/2022 06:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/28/2022 at 03:54 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439.1(b)(6)(A)
Infant Care Center Sleeping Equipment
(6) Crib mattresses shall be: (A) Covered with vinyl or similar moisture-resistant material.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in three out of three crib mattress were covered in a cloth material not a vinyl or similar moisture-resistent material, as required which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2022
Plan of Correction
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Per facility representative new mattress converings will be purchased.
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above when vinyl blocks on the shelving units in the infant room, had tears along the edges and corners of the materials. In addition LPA observed the molding at the base of the wall was ripped and had a sharp edges exposed, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2022
Plan of Correction
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2
3
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Per facility representative the vinyl blocks will be removed and the molding will be replaced. Documentation will be submitted to the Department.
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


LIC809 (FAS) - (06/04)
Page: 6 of 15
Document Has Been Signed on 06/28/2022 06:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/28/2022 at 03:58 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439(k)(2)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(k) Toy storage containers shall meet the following requirements: 2) All edges and corners shall be rounded and padded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in one of the low shelving units did not have rounded edges which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/13/2022
Plan of Correction
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Per facility representative corner covers will be purchased for the shelving unit
Type B
Section Cited
CCR
101226(d)(1)
Health-Related Services
(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children: (1) A current edition of a first-aid manual.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in one of one first aid kit located in the infant room did not contain a current edition of a first aid manual which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2022
Plan of Correction
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Per facility representative a current edition of the first aid manual will be purchased and added to the first aid kit
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


LIC809 (FAS) - (06/04)
Page: 7 of 15
Document Has Been Signed on 06/28/2022 06:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/28/2022 at 04:01 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on [(record review)], the licensee did not comply with the section cited above when the last disaster drill was completed in October 2020 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2022
Plan of Correction
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Per facility representative, a disaster drill will be conducted every six months. The facility will set up a system to ensure the disaster drills are completed.
Type B
Section Cited
CCR
101238.2(d)(1)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above when the soft mats which were previously secured to the concrete were not secured at the time of this inspection. Mats were observed upside down with the glue exposed and scattered around the outdoor activity area, the mats posed a potential tripping hazard to the infants in care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2022
Plan of Correction
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2
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Per facility representative the area will be cleaned up and the all hazards will be removed
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


LIC809 (FAS) - (06/04)
Page: 8 of 15
Document Has Been Signed on 06/28/2022 06:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/28/2022 at 04:03 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

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
1
2
3
4
Based on observation, the licensee did not comply with the section cited above when the outdoor licensed space, was observed to have nails, construction materials, empty beer bottles, water bottles, used facial masks, and additional trash accessible to the children in the licensed space. Furthermore there were 6 inch plants growing in licensed space, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/01/2022
Plan of Correction
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2
3
4
Per facility representative, the outdoor area will be cleaned up and all trash will be removed from the area.
Type B
Section Cited
CCR
101238.2(f)
Outdoor Activity Space
(f) Sandboxes shall be inspected daily and kept free of hazardous foreign materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above when the sandbox had five piles of animal feces. Based on LPA observation the area was not inspected daily and kept free of hazardous material which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/29/2022
Plan of Correction
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2
3
4
Per facility representative the feces will be removed and the sand box will be inspected by the staff
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


LIC809 (FAS) - (06/04)
Page: 9 of 15
Document Has Been Signed on 06/28/2022 06:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/28/2022 at 04:05 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in four of six staff files reviewed were missing documentation that the employee had received or declined the influenza vaccination between August 1 and December 1 of 2021, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2022
Plan of Correction
1
2
3
4
Per facility representative the staff files will be updated to include the influenza statements.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on record review, the licensee did not comply with the section cited above in two of six files reviewed did not have documentation that the mandated reporter training had been renewed within the last two years, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2022
Plan of Correction
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Per facility representative the staff will completed the mandated reporter training as required.
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


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Created By: Kendal Zirbes On 06/28/2022 at 04:09 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in eight of ten infant files reviewed were missing a medical assessment of the child preformed a licensed physician, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Per facility representative, the infant files will be updated with the required information.
Type B
Section Cited
CCR
101229.1(a)(1)
Sign In and Sign Out
(a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above when C1 was at the Center five days in June The sign in and out sheets for all five days did not have the time that C1 was signed into the Center. Furthermore, on June 17 and 20 the sign in and out was missing the signature of the person who signed C1 into care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/05/2022
Plan of Correction
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Per facility representative the staff will speak to the parent about the sign in an out procedures. Sing in and out sheets will be updated
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


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Created By: Kendal Zirbes On 06/28/2022 at 04:13 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on record review, the licensee did not comply with the section cited above in nine of ten infant Needs and Services Plans were not signed by the Center staff they were completed by the Parent which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2022
Plan of Correction
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Per facility representative the center will start completing the needs and service plan as required. A plan for how the needs and service plans will be completed shall be submitted to the Department
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on record review, the licensee did not comply with the section cited above in four of the ten infant files reviewed were missing an individual Infant Sleeping Plan as required, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/12/2022
Plan of Correction
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2
3
4
Per facility representative, individual safe sleep plans will be completed for each child 0-12 months of age.
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


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Created By: Kendal Zirbes On 06/28/2022 at 04:15 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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844264

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in four out of the ten infant files reviewed did not have the Needs and Service Plans updated quarterly as required, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/01/2022
Plan of Correction
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2
3
4
Per facility representative the needs and service plans will be completed quarterly as required. The Center will develop a plan to monitor the Needs and service plans.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


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