364844478-4-10-2023-12-CC-KZIS-CQRVED-20230410162209

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364844478
Report Date: 04/10/2023
Date Signed: 04/10/2023 04:22:29 PM

Document Has Been Signed on 04/10/2023 04:22 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:	DEL ROSA PRESCHOOL		FACILITY NUMBER:	364844478
ADMINISTRATOR:	CASTANEDA, DELIA		FACILITY TYPE:	850
ADDRESS:	3395 MOUNTAIN AVENUE		TELEPHONE:	(909) 880-6706
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 20	DATE:	04/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Facility representative, Dawn Mendoza		TIME COMPLETED:	04:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Zirbes met with the Facility Representative Dawn Mendoza for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the entire center, which consists of one classroom with two bathrooms and an outdoor play space. The classroom is located on Del Rosa Elementary campus. LPA observed a total of 20 preschool age children with one teacher, and two aides providing supervision. The facility operates two half day programs Monday to Friday. 08:30 AM -11:30 AM for the AM Session and 12:30-3:30 PM for the PM Session. Indoor/Children’s Area: Child care center was observed to be clean and sanitary. Outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in a key locked cabinet within the classroom. LPA observed three tables and multiple chairs to meet the needs of the children. LPA observed the classroom had designated areas for dramatic play, computer center, science center a reading area. In addition, there was a carpet area for story time/instructional area. Children's belongings are kept in cubbies labeled with the children's names. During the safety walk inspection, LPA observed the blue vinyl mat on the floor of the reading center had more than five large tears in the vinyl. Therefore the equipment was not maintained in good condition. Facility representative stated a new mat was ordered 3/2/23. An advisory notice was issued to remind the facility that all fixture, furniture and equipment shall be in good condition. Trash cans for solid waste have tight fitting lids. Drinking water is readily available indoors via a drinking fountain and bottled water. Required Lead testing occurred 2.22.23. All materials and surfaces are toxic free, window screens in good repair and free of debris. The classroom was equipped with a carbon monoxide detector. The Classroom has working telephone service. There is an isolation area for children who become ill. The isolation area is located within the classroom. The facility maintains a comfortable temperature at all times. Sign in/out is completed via an electronic system each day. Smoking prohibited on the premises, daily inspection for illness is completed. Report continued on page two

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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: DEL ROSA PRESCHOOL	FACILITY NUMBER: 364844478
	VISIT DATE: 04/10/2023

NARRATIVE

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LPA did not observe prohibited child care items at this time. Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. There are zero window cords in the classroom. Firearms/weapons are not allowed or stored on premises. There are no bodies of water on the premises. The school meal program provides meals to the children. Meals are prepared in the school cafeteria. Menus were posted in the classroom.
Napping
The preschool program only offers a half day program. Therefore, the children do not nap at the facility. The classroom has a designated areas for relaxation and quite play
Restrooms
There are two bathrooms located within the classroom each equipped with one toilet. The sink for hand washing is located in the classroom between the two bathrooms. Both restrooms were in safe and sanitary operating condition at the time of this inspection. The sink for hand washing only delivers cold water. LPA observed paper towels and soap available.
Outdoor
The preschool has a large enclosed outdoor play area. The outdoor play area, had a shaded rest area. LPA observed a large climbing structure and swings for the children. The was cushioning material under the climbing structures and swings. The play structure and swings were securely anchored to the ground. No bodies of water were observed. There is an approved waiver on file for the outdoor play area. The waiver was posted on the parent board.

Health Related Services
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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. At the time of this inspection zero children were being provided with medications.
Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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: DEL ROSA PRESCHOOL	FACILITY NUMBER: 364844478
	VISIT DATE: 04/10/2023

NARRATIVE

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Staff/Personnel Records
LPA reviewed ten child records and three staff files during this inspection. Records were complete and contained the required documentation.

Facility Records

LPA observed a current roster, disaster drill log, current CPR/First Aid with expiration date of 2/18/24 .

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393L), car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist. LPA did not observe the phone number to the local health department posted. An advisory notice was issued.

Topics discussed with facility representative:

LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Director shall permit the Department to inspect the center, and to privately interview children or staff, to determine compliance with or to prevent violations of 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.

Facility representative 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.

Report continued on page four

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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: DEL ROSA PRESCHOOL	FACILITY NUMBER: 364844478
	VISIT DATE: 04/10/2023

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Topics discussed with facility representative (continued):

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department (email address unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

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 license 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.

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/inspection-process

Based on LPA observations today, zero citations were issued however three advisory notices were provided.

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 Dawn Mendoza .

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC809 (FAS) - (06/04)

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