143801727-10-21-2025-12-CC-CALI-DMNUBJ-20251021152626

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 143801727
Report Date: 10/21/2025
Date Signed: 10/21/2025 03:27:00 PM

Document Has Been Signed on 10/21/2025 03:27 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:	ICOE-BIG PINE STATE PRESCHOOL		FACILITY NUMBER:	143801727
ADMINISTRATOR/ DIRECTOR:	KAT DUNCAN		FACILITY TYPE:	850
ADDRESS:	500 S. MAIN STREET		TELEPHONE:	(760) 938-2222
CITY:	BIG PINE	STATE: CA	ZIP CODE:	93513
CAPACITY: 23	TOTAL ENROLLED CHILDREN: 23	CENSUS: 4	DATE:	10/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:45 PM
MET WITH:	Miriam Rico, Lead Teacher		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/21/25, Licensing Program Analyst (LPA) Crystal Ali met with Miriam Rico, Lead Teacher, for the purpose of an unannounced Annual/Random inspection. LPA disclosed the purpose of the inspection and was granted entry to the facility by Amber Fletcher. Upon arrival. Teacher/child ratios was observed. LPA observed 4 children, 2 teachers present during this inspection. Preschool consist of one classroom for part time and full time students. The facility hours of operation are from 7:45am to 4:15pm, Monday-Friday. Incidental Medical Services (IMS) were discussed. There are no current children with medical needs. Staffing Ration and Capacity: Upon arrival, LPA observed 1 classroom in use with a total of 7 enrolled in preschool class. Physical Plant: LPA toured and inspected the preschool classroom. Furniture and equipment were checked for age appropriateness and good repair. All areas are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings labeled with their names. LPA observed age-appropriate toys and materials.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE

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Daily activities schedule was observed in each classroom. The classroom has bathroom for children, bathroom for staff, kitchenette, staff office, and play yard.

Kitchen/Food service: There is a clean kitchen (off limits) with a refrigerator, freezer, toaster oven and microwave oven. The facility provides morning snack, lunch, and afternoon snack for full time students. Part time students bring their own lunch, and it is stored in the refrigerator with their name on it. Allergy lists are posted in the kitchen and child files. LPA observed an appropriate amount of food and snacks and staff preparing lunch (with gloves). The chemicals are kept separate from the food under the sink. Cabinet under the sink needs lock replaced or safety latch added to the right cabinet. LPA observed chemicals stored up high inaccessible to children in children bathroom. LPA observed that food preparation and storage areas are kept clean and free of litter and rubbish. Soaps, detergents, cleaning compounds, or similar substances are stored separately from food supplies. Menus are posted at least one week in advance and made available for review by the parents. The facility does participate in the food program.

Napping: Per Teacher, children do nap on site from approx. 12pm-2pm, daily. Facility has a surveillance system on the premises. The bedding is stored separately and properly. The sheets and blankets are washed weekly. Cots are sanitized daily. Drinking water is available inside the classrooms in the form of disposable water color cups.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE

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Fire Extinguisher: Emergency Drills are conducted at least every six months and the last drills were conducted and documented on 10/14/25 (earthquake) and 10/16/25 (fire). The fire extinguishers (3A40BC) are reading in green and meets the Fire Marshall Codes and Standards (last serviced 6/10/25). One fire extinguisher is at the front door of classroom. Teacher stated she is unsure of when the fire marshall came last to inspect the facility. Administration office would have that information since preschool is on elementary school grounds. LPA observed a 2 first aid kits, 1 AED kit, and 1 bleeding kit station at the front door.
Bathroom: Age-appropriate sinks and toilets were inspected for availability and good repair. One toilet flushed properly, and one sink reachable by the children. Each restroom has adequate toilet paper, hand soap, and paper towels available. There is one staff bathroom for teachers. Restrooms are cleaned, restocked with toiletries, and sanitized by on-site staff.
Medication: Children are inspected for illnesses as they arrive with a no-touch thermometer and an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission. The teacher and other administration staff will administer medication and document the dosage, date, and time on a log. Medication is brought and locked at the center (unless the parent requests daily return) and stored above the refrigerator in locked box. Medication is labeled correctly and stored in its original container. There are currently no children in care with IMS needs. Isolation area is located next to the staff desk in the back of the classroom. The teacher has them seat the kids away from other kids until parents come to pick them up.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE

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Pet: LPA observed a fish tank in the classroom that has three goldfish. LPA observe fish food located in the staff office area off limits to the children. Teacher states she cleans the fish tank once a week when there are no children present.

The Outdoor: The play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The play area has a playground is a large sandbox with anchored play equipment. The play area was inspected and found to be free of hazards and inaccessibility to bodies of water. The playground has an area on side of the preschool building that houses all the tricycles and a locked shed. The children utilize their own water bottles for usage when at the playground. There is garden section for the children to learn how to care for plants. Garden tools are locked up in the shed when not in use.

Transportation: The facility does not provide transportation for the children.

Lead Testing/Drinking Water: The facility has had lead testing completed 3/10/23. Facility passed the lead test. Copy of report was provided to CCL and is on file.
The parent board was reviewed and has all the required forms posted. Sign-in and out sheets were reviewed. The Teacher to child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if the children’s basic needs were met and appropriate.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE

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Records/Documentation: LPA reviewed with facility representative the LIC 125, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. Staff Records/ Children Records: Staff (2) and Children's (2) records were reviewed. Staff and children files are both in compliance.

The following general information was discussed during this inspection:
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Criminal Record Clearance - Child Care Centers
Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE

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Lead Testing – Child Care Centers (CCC)
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.
Safe Sleep - Child Care Centers
LPA discussed the safe sleep regulations with facility representative and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/
safe-sleep as an additional resource. LPA also informed or facility
representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

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Incidental Medical Services (IMS) - Child Care Centers
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
PIN 22-05-CCP.
MyChildCarePlan.org – Child Care Centers
Facility representative was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Subscribe to CCLD important information - Child Care Centers
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ICOE-BIG PINE STATE PRESCHOOL	FACILITY NUMBER: 143801727
	VISIT DATE: 10/21/2025

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	No deficiency was cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes. Notice of site visit was given and is to remained posted on parent board for 30 days. Exit interview conducted and report was reviewed with the Miriam Rico, Lead Teacher.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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