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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 04:13:18 PM

Document Has Been Signed on 06/06/2024 04:13 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: 38CENSUS: 24DATE:
06/06/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:01 AM
MET WITH:Facility Representative Ghada Ponce TIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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On June 6, 2024 at 11:01 a.m., Licensing Program Analyst (LPA) Zirbes met with the facility representative Ghada Ponce. The purpose of the inspection was to conduct an unannounced required Annual/Random inspection. During the inspection, LPA toured and inspected the preschool program in accordance with the facility sketch. At the time of this inspection there were 24 preschool age children at the facility, four teachers, one aide and three additional support/administrative staff. Based on LPAs observation during the walk through today, the Center was meeting the required staff to child ratios. The Center is operated on the grounds of First Presbyterian Church. The preschool/toddler Center consists of three classrooms, four restrooms, staff restrooms and an outdoor activity space. The center also operates a Infant Center (#367750050). Both licensed components utilize the kitchen, staff restroom, staff offices, staff lounge, storage spaces. The center operates 6:30 a.m.-6:00p.m., Monday through Friday.
Indoor/Children's Area: Indoor activity space for preschool age children is physically separate from space used by children in the infant and toddler components. The preschool utilizes classroom 6 and 4. The toddler options is operated out of Room 3. Each classroom is equipped with appropriate furniture and equipment. LPA observed a dramatic play areas, with dress up clothes, a variety of manipulatives, art supplies, and a library area. Furniture is maintained in good repair and safe condition (age appropriate). Toys and materials were observed to be in good condition. Each classroom had storage areas for the children to place their personal items. Drinking water is available inside the classroom via personal water bottles and a Brita water container. Based on LPA observation and statement from facility staff, all chemicals and cleaning supplies were stored within the classrooms in cabinets equipped with child safety locks. Cleaning products are also located in the staff lounge and kitchen. The building has heating and air conditioning. The Center was a comfortable temperature at the time of this inspection. LPA observed a carbon monoxide detector, smoke detectors and fire extinguishers throughout the building.
Report continued on page two
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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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: OAK TREE D STREET
FACILITY NUMBER: 367750049
VISIT DATE: 06/06/2024
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Report continued from page one
Indoor/Children's Area continued: The Center has a working telephone on the premises. There is an isolation room for ill children. Smoking is prohibited on the premises. Teachers conduct daily inspection for illnesses. LPA did not observe prohibited childcare items during this inspection. Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises, facility representative confirmed there are zero bodies of water on the premises.
Restrooms: Room 6 has one toilet and two hand washing sinks. Room 3 and room 4 each have one hand washing sink and share one toilet. A girls restroom with two sinks and four toilets and a boys restroom with two urinals and three toilets are available and located within the courtyard. Restrooms were observed to be in safe and sanitary operating condition. Toilets and sinks are functioning properly and are age appropriate. Paper towels and soap were available to the children. During the tour of the Center with the facility staff, LPA observed toilet paper was not present in the toilet paperholders. The toilet paper was placed on a high shelf inaccessible to the children. When the children access the bathroom, the teacher was assisting in providing the supplies. LPA advised the Center ensure toilet paper is readily accessible to the children in order to provide comfortable accommodations. During the inspection, toilet paper was placed into the toilet paper holder. A technical violation was issued.
Meals: The Center provides breakfast, lunch and two snacks. The Center has a kitchen on grounds where all meals are prepared. The kitchen is located in a separate building on the church grounds. All cleaning products were stored in areas separate from the food. Menus were posted in the classrooms, and kitchen. LPA reminded the facility representative to post the menus at least one week in advance.
Napping: The children nap in their individual classrooms on cots. Cots were observed in good condition. Outdoor: LPA inspected the outdoor play space for health, safety, and age appropriateness. There are 2 separate outdoor activity spaces, one for the Preschool component and one for the toddlers/infants. LPA observed the toddler outdoor space had one climber, two dramatic play areas and a sand box. The climbing structure was securely anchored to the ground and was placed on a rubber surfacing material to absorb falls. The preschool outdoor activity space consists of one large climber, two swings, a cement track and grass area. The climbing structure and swings were securely anchored to the ground and were placed on wood chips to absorb falls. LPA advised the facility representative to monitor the depth of the wood chips placed under the high climbing equipment and swings to ensure the the wood chips are of a depth that absorbs falls. Report continued page three
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
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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: OAK TREE D STREET
FACILITY NUMBER: 367750049
VISIT DATE: 06/06/2024
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Report continued from page two

Outdoor continued: In the outdoor activity space for the preschool children, LPA observed brown and green weeds that were over six inches in height. In addition, LPA observed two wooden tables in the outdoor sandbox and another wooden figurine near the sand box that had rough edges and peeling paint. During LPAs inspection children played in the outdoor activity space. Per conversation with the facility representative a teacher is stationed near this area to prevent the children from playing in this area. Based on LPAs observation, a physical barrier is not present which prevents the children from accessing these areas, therefore this is a potential hazard to the children in care. A type B citation was issued refer to LIC 809D. During LPA inspection, the weeds were removed and the wooden tables were sanded down.
When engaged in outdoor play, water is accessible to the children via individual water bottles brought out with the teacher.

Transportation: The facility does not provide transportation.

LPA was unable to complete the entire annual inspection on this date. Therefore LPA will return on a future date to complete the annual inspection.


As a result of this inspection, one type B citation was issued along with two advisory notices.

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
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/06/2024 04:13 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 06/06/2024 at 02:04 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: OAK TREE D STREET
FACILITY NUMBER: 367750049

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/06/2024

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
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Based on observation, the licensee did not comply with the section cited above when brown and green weeds, and wood with sharp edges and peeling paint was observed in the outdoor activity space accessible to the children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/14/2024
Plan of Correction
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During this inspection, the weeds were removed and the wood was sanded down. Per Facility representatives opening and closure procedure will be created for the staff to follow. A staff training will occur. A copy of the training and sign in sheet along with the closure procedures will be submitted to the Department.
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:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 06/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2024


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