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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750049
Report Date: 06/06/2024
Date Signed: 06/06/2024 04:11:41 PM

Document Has Been Signed on 06/06/2024 04:11 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:OAK TREE D STREETFACILITY NUMBER:
367750049
ADMINISTRATOR/
DIRECTOR:
MELISSA DAVISFACILITY TYPE:
850
ADDRESS:1900 D STREETTELEPHONE:
(909) 882-6979
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 50TOTAL ENROLLED CHILDREN: 36CENSUS: 24DATE:
06/06/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Facility representative Ghada Ponce TIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On June 6, 2024, at 08:40 a.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced case management Lead Testing/Exceedance inspection for the purpose of notifying the facility there has been a lead exceedance referred for an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility. LPA met with facility representative Ghada Ponce. LPA disclosed the purpose of the inspection and was granted entry into the facility. Seven toddlers and 18 preschool age children were present at the Center during the inspection. Four teachers and one aide were providing supervision, additional administrative staff were present.

Palmdale Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on the records reviewed outlet (E) an indoor sink faucet located in the staff lounge (Room 5) had an ALE of 8.6.

Per conversations with facility representatives, outlet (E) has only been utilized by the staff members for hand washing purposes only. Per conversations, art projects or learning activities that include food preparation do not utilize the water from outlet (E). Furthermore, interviewees reported the Brita water jugs located within the classrooms, have never been filled with water from outlet (E). Staff Interviewees reported, the preschool children have never utilized outlet (E). During LPAs facility tour today, LPA observed a sign stating Hand Washing Only on the wall behind Outlet (E).

Based on interviews and observations, outlet (E) is a hand washing sink only located in the staff lounge. Outlet (E) has not been utilized by the child care children. Therefore citations were not issued.

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 Ghada Ponce.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2024
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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