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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750050
Report Date: 10/20/2022
Date Signed: 10/20/2022 10:29:59 PM

Document Has Been Signed on 10/20/2022 10:29 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:
367750050
ADMINISTRATOR:JENNIFER CARTERFACILITY TYPE:
830
ADDRESS:1900 D STREETTELEPHONE:
(909) 882-6979
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
10/20/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jennifer CarterTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Maddox met with Jennifer Carter, Applicant for the purpose of conducting a Pre-Licensing inspection for an Infant component (for children ages 6 mos. to 2 years) in Room #s 1 & 2. Applicant requested a capacity of 12 Non-amb infants however the Fire Inspector has limited the capacity of Non-Amb to 6. Room #1 will be for the Non-Amb Infants and Room #2 will be for the Ambulatory Infants (ages 12 mos to 24 mos.). The hours of operation will be from 6:30 am to 6:00 pm Mon- Fri. Applicant is also applying for a Preschool License at this location (367750049)

INDOOR ACTIVITY SPACE: A comfortable temperature for children shall always be maintained. Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities. Tables and chairs were present to meet the needs of the children. Drinking water is readily available Water Pitchers with disposable cups and water bottles labeled with each child's name. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children will be stored in locked cabinets inaccessible to children. There is a fully stocked first-aid kit kept in the office with mini kits in the classroom.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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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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: 367750050
VISIT DATE: 10/20/2022
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The isolation area will be located in the office for any child who becomes ill during the day. LPA observed working carbon monoxide detectors throughout and smoke detectors and fire extinguishers throughout the facility.
Center will use the bright wheel system to sign children in and out, with the capability to print out a hard copy if needed. The licensee shall conduct a well-ness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
OUTDOOR

There are 2 separate outdoor play yards, one for the Preschool and a separate one for Infant/Toddlers. The Infant/Toddler yard was observed to have rubber matting as cushioning material, age appropriate equipment, with trees providing natural shade. Staff will bring water pitchers out for drinking water. There are no bodies of water on the premises, and the play yard is totally fenced.

RESTROOMS

There is a bathroom in this split classroom that has 1 toilet and 1 sink.

CHILDREN’S RECORDS:


All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. All Infant records should contain a Needs and Service Plan.
NAPPING

Room #1 has cribs available for the younger infants and Room #1 will have cots for sleeping.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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: 367750050
VISIT DATE: 10/20/2022
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INFANTS:
Applicant was informed of new Safe Sleep Regulations (101439.1 Infant Care Center Sleeping Equipment and the requirement to check on Infants every 15 minutes including documentation.
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
Date, Infant’s name, Time of each 15-minute check, and
the Initials of staff person who conducted each check.Applicant was informed of the following for Infants sleeping equipment.
(1) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
(2) Mattresses shall be made specifically for the size crib in which they are placed.
(3) Stacking wall cribs or cribs stacked one on top of another, often referred to as tiered cribs, shall not be permitted.
(4) Cribs shall not limit the ability of staff to see the infant.
(5) Cribs shall not limit the infant's ability to stand upright.
(6) Crib mattresses shall be:
(A) Covered with vinyl or similar moisture-resistant material.
(B) Wiped with a detergent/disinfectant daily and when soiled or wet.
(C) Maintained in a safe condition with no exposed foam, batting or coils.
Each crib, mat or cot shall be occupied by only one infant at a time. Each infant's bedding shall be used for him/her only.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: 367750050
VISIT DATE: 10/20/2022
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Such bedding shall be replaced when wet or soiled, or when the crib, mat or cot is to be occupied by another infant. Bedding shall be changed daily, or more often if required. Soiled bedding shall be placed in a suitable container and made inaccessible to infants until washed or picked up by a commercial laundering service.
Cribs shall be free from all loose articles and objects, including blankets and pillows.
(1) Pacifiers shall be allowed in the crib if the following provisions are in place:
(A) There shall not be anything attached to the pacifier.
(B) The pacifier shall be specific to the infant it is being given to.
(2) Bumper pads shall not be used.
(3) There shall be no objects hanging above or attached to the side of the crib.
Cribs, mats or cots shall be arranged so as to provide a walkway and work space between the cribs, mats or cots sufficient to permit staff to reach each infant without having to step over or reach over any other infant.
Placement of cribs, mats or cots shall not hinder entrance or exit to and from the napping space. Infants up to 12 months of age should have a completed Individual Infant Sleeping Plan (LIC 9227), a copy must be maintained and kept in the infant’s file and updated as needed.
HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children.

A refrigerator shall be used to store any medication that requires refrigeration.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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: 367750050
VISIT DATE: 10/20/2022
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 There is a refrigerator available to store any medication that requires refrigeration. All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption. Food in damaged containers shall not be accepted, used or retained.
Applicant has a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.

POSTINGS:

The licensee shall post signs at the entrance to the child care center that provide the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5

Applicant was informed is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.


Fire Clearance has been received for 6 non-amb infants and 6 amb infants.
Measurements:
Room #1 - Non-Amb area: 16 X 15 = 240/35 = 7
Room #2 - Amb - 30 X 20 600/35=17
Bathroom: 1 toilet and 1 Sink = 15
Outside: 30 X 70 = 2100/75 = 28
Needed Prior to Licensure: See Report for facility # 367730049
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: 367750050
VISIT DATE: 10/20/2022
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Licensee has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

FOOD SERVICES

Parents will provide formula for Infants, the older infants will be apart of the food program. Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies. Food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin. Trashcans, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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