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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750009
Report Date: 08/05/2022
Date Signed: 08/05/2022 03:32:54 PM

Document Has Been Signed on 08/05/2022 03:32 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:BARSTOW HEAD START/STATE PRESCHOOLFACILITY NUMBER:
367750009
ADMINISTRATOR:PAMELA MCQUAINFACILITY TYPE:
850
ADDRESS:1121 W MAIN STREETTELEPHONE:
(888) 543-7025
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY: 66TOTAL ENROLLED CHILDREN: 66CENSUS: 16DATE:
08/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:39 PM
MET WITH:Deborah HarrisTIME COMPLETED:
03:59 PM
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Licensing Program Analysts (LPA) Babatunde Ibitoye met with program generalist Deborah Harris , today for the purpose of conducting an unannounced Annual/Random inspection for the Barstow Head start . There are 9 children present upon arrival with 2 teachers in classroom 91 and 7 Children with 2 teacher in Classroom 90, the hours of operation are 7:00 AM - 5:00 PM Monday - Friday. LPA verified there is at least 1 staff person present with current CPR and First Aid training (exp. 09-21-23)

During the time of the inspection, LPA observed and reviewed records to verified accuracy:


1. Sampling of children's (5) records (See LIC 857)
2. Sign In and Out sheets were inspected.
3. Emergency contact information observed
4. Parent board observed
5. Staff personnel files reviewed for educational and certification(See LIC 859 & LIC 500)
6. Pediatric CPR and First Aid training for one staff
7. Mandated Reporter Training
8. Emergency Fire Drills were current and up to date
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2022
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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Document Has Been Signed on 08/05/2022 03:32 PM - It Cannot Be Edited


Created By: Babatunde Ibitoye On 08/05/2022 at 02:39 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: 08/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/10/2022
Plan of Correction
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Site will provide proof of mandated reporter certificate for Staffs by due date
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:
DATE: 08/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2022


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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: BARSTOW HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 367750009
VISIT DATE: 08/05/2022
NARRATIVE
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*Snack/lunch menus, Allergy list were reviewed and posted. Food and snacks were reviewed for availability, quantity, proper storage, and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. (1 freezer 1 refrigerator, sink, stove/oven).

*Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored in storage locked cabinet.

* LPA observed 4 Classrooms, Bathrooms (4) noted all toilets , sinks (4) were sanitary and operational. LPAs observed soap, paper towel and toilet paper and water tested at a safe temperature. Each classroom has a bottle water, disposable cups, cubbies with children's names identified and napping equipment.

*All flooring was found to be clean and safe.

**Teacher/child ratio observed, care and supervision was discussed, children's records were reviewed, parent board observed and fire drills are current. Fire extinguisher operable.

*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.

*First Aid supplies were inventoried, a review of medication policy, including administering, labeling, and storage. *Telephone service, heating, lighting and ventilation were evaluated.

*Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness, LPAs noted shade, and drinking water: There are no bodies of water on the premises.

*Isolation area is located in the front Office.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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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: BARSTOW HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 367750009
VISIT DATE: 08/05/2022
NARRATIVE
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ADMINISTRATION:

*Program generalist is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.

*There were no excluded individuals present; staff present were fingerprint cleared and associated.

A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Teacher administers medication and documents the dosage, date and time onto a log. Medication remain on site in under lock and key .Medication is properly labeled and stored in its original container.

LPA discussed the following:

Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements

Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include: Serious health and safety violations resulting in Type A citations;

· Non-compliance conferences; or Efforts by the Department to revoke a facility’s license. Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Failure to meet the posting requirements shall result in an immediate civil penalty. In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to

.Center was found to be operating within its specified ratio and capacity.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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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: BARSTOW HEAD START/STATE PRESCHOOL
FACILITY NUMBER: 367750009
VISIT DATE: 08/05/2022
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 Deficiencies Cited : one deficiencies are being cited in accordance to Title 5 of the California Code of Regulations and/or Health & Safety codes. See LIC 809D .

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.

Exit interview conducted with generalist Deborah Harris. A copy of the Appeal Rights (LIC 9058) were given and explained. Program generalist signature on this form acknowledges receipt of these rights.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC809 (FAS) - (06/04)
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