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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750009
Report Date: 12/18/2025
Date Signed: 12/18/2025 03:44:55 PM

Document Has Been Signed on 12/18/2025 03:44 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BARSTOW HEAD START/STATE PRESCHOOLFACILITY NUMBER:
367750009
ADMINISTRATOR/
DIRECTOR:		PAMELA MCQUAINFACILITY TYPE:
850
ADDRESS:1121 W MAIN STREETTELEPHONE:
(888) 543-7025
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY: 66TOTAL ENROLLED CHILDREN: 66CENSUS: 5DATE:
12/18/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Neena MalhotraTIME VISIT/
INSPECTION COMPLETED:
03:44 PM
NARRATIVE
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On December 18, 2025, Licensing Program Analyst (LPA), Calloway conducted an unannounced inspection to the above facility. The purpose of the inspection was to conduct a case management inspection to follow up on an incident that occurred at the facility. LPA met with the Neena Malhotra, who granted access. LPA toured the facility with the representative and observed five-day care children and two staff in care.

On December 5, 2025, at 11:17 AM, a Child (C1) was trying to help get a toy under the changing table when their finger got caught underneath the table. LPA conducted interviews with all relevant parties. Based on interviews, Staff had to assist C1 in removing their hand from underneath the changing table and C1 sustained an injury to their left index finger fingernail. Staff cleaned the child’s finger with soap and water and provided an ice pack. The incident was reported to C1’s parent and a written incident report was completed. The Staff followed the necessary protocol in providing aid and reporting the incident to the parent. The Staff did not report the incident to the Community Care Licensing (CCL) office when the incident occurred according to the regulations.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BARSTOW HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 367750009
VISIT DATE: 12/18/2025
NARRATIVE
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During this inspection, LPA observed C1’s injury and the changing table where the injury occurred. The diaper changing table has two open gaps at the bottom on each side of the table. These openings are within the reach of children and create a potential entrapment hazard as a child could place their hand into the gaps and become caught and/or injured.

There are two Type B deficiencies cited during this inspection. See LIC 809D pages attached to this report.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit (LIC 9213), and Appeal Rights were provided to Neena Malhotra, 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.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/18/2025 03:44 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 12/18/2025 at 02:55 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: BARSTOW HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 367750009

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2025
Section Cited
CCR
101212(d)(1)(C)

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101212(d)(1)(C)ReportingRequirements (d) Upon the occurrence, during the operation of the child care center of any of the events...report shall be made to the Department...(1)Events reported shall include the following:(C) Any unusual incident...This requirement was not met as evidenced by:

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I will provide a report at the same time the incident occurred moving forward. I will provide a statement to Licensing regarding this.
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Based on interview and record review Child 1 (C1) tried to help get a toy from underneath the changing table when their left hand was caught underneath the table. C1 sustained an injury to the left finger fingernail. Staff provided aid and reported the incident to the parent, but did not report the incident to the Community Care Licensing (CCL) office which is a potential health, safety, or personal rights risk to the persons in care.
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Type B
01/09/2026
Section Cited
CCR101223(a)(2)

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101223(a)(2) Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.This requirement was not met as evidenced by:
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I will put a work order and see if they can put some silicone or wood in the gapped areas on the changing table. I will provide a copy of the work order and proof of repair to Licensing.
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Based on observation interview and record reivew. LPA observed the diaper changing table inside the classroom with two gapped openings at the bottom on each side. The openings are in reach of the children and they can place their hand inside causing entrapment and/or injury which is a potential health, safety, or personal rights risk 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.
Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:
Kuliema Calloway
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2025


LIC809 (FAS) - (06/04)
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