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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801889
Report Date: 05/23/2024
Date Signed: 05/23/2024 01:33:25 PM

Document Has Been Signed on 05/23/2024 01:33 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:WIND IN THE WILLOWS PRESCHOOL, THEFACILITY NUMBER:
153801889
ADMINISTRATOR/
DIRECTOR:		ASHLEY KOSTOPOULUSFACILITY TYPE:
850
ADDRESS:12200 DEL ORO STREETTELEPHONE:
(760) 762-1700
CITY:BORONSTATE: CAZIP CODE:
93516
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 0DATE:
05/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Ashley KostopoulusTIME VISIT/
INSPECTION COMPLETED:
01:32 PM
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On May 23, 2024, at 9:35 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the School Director, Ashley Kostopoulus (D1) to conduct an unannounced Annual/Random inspection for the preschool license in accordance with the facility sketch. A tour of the facility was conducted. LPA observed a total of zero preschool children in the classroom with four staff presents. The preschool classroom operates Monday to Friday, from 8:30 A.M. to 11:30 A.M. The school has a three hour program.

Indoor/Children’s Area:
The room is clean, safe, sanitary and in good repair; the entrance and exit doors of the classroom is kept free of obstructions; floors of the room have a surface that is safe and clean, teachers used spray bottles disinfectants to sanitize rooms, furniture/equipment is in good condition and is free of flies, other insects, and rodents; tables/chairs provided to meet children’s needs. Per Director Kostopoulus (D), the rooms are being sanitize every day. Cleaning compounds are kept inside the cabinet in the bathroom for staff. All play equipment and materials used by children are age-appropriate, each child has an individual storage space (cubby, individually labelled with name) for his/her clothing, personal belongings. There is a working telephone. Electrical outlets are inaccessible to children in care. Recalled and or prohibited toys or sleep/play equipment were not observed on the premises. There are no window cords accessible to children.

Water fountains are available at the play area. All materials and surfaces are toxic free. There is no fireplace in the facility. The center has an internal pull-down fire alarm system and fire extinguishers with 2-A:10-B:C classification and the last service date was on November 17, 2023 (reading in green, checked at 10:17 and 10:26 A.M.). Carbon monoxide devices are in operable condition (tested at 11:18 A.M.).

Restrooms: LPA inspected and observed two bathrooms inside the classroom. LPA also observed liquid soap, paper towel, toilet paper, and trash bins inside the bathroom. Water temperature is appropriate. The director’s office is used as an isolation area for children who become ill while in care. The facility maintains a

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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: WIND IN THE WILLOWS PRESCHOOL, THE
FACILITY NUMBER: 153801889
VISIT DATE: 05/23/2024
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comfortable temperature at all times, first aid supplies (first aid manual/guide, bandages, scissors, tweezers), sign in/out sheets available and completed daily. Smoking is prohibited on the premises, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Per director Kostopoulus, children do not nap in the classroom.

Outdoor: The facility has one playground area for the preschool children. The play area is made of sand and concrete and has a canopy covering the play equipment. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. The area was observed to be free of debris, free from hazard, holes, broken items, debris. Water fountain is available at the play area. No bodies of water were observed.

Health Related Services: Per Director Kostopoulus, the facility does not provide medications to children in care. Children are inspected for illnesses (wellness policy) as they arrive. The director was advised that if medications are administered, they have to send an Incidental Medical Services Plan to the Licensing. The administration of medications would be provided only with parent's written permission and a doctor's note. Facility was also advised that the medication must be properly labeled and stored in its original container.



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

The Director stated that they were not providing transportation to preschool children. Parents drop them off at the center.



Food Service: The facility only provides snacks.

Staff/Personnel Records: Designation of Responsibility observed, immunization's, TB clearance, health

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
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: WIND IN THE WILLOWS PRESCHOOL, THE
FACILITY NUMBER: 153801889
VISIT DATE: 05/23/2024
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screening, criminal record statement, statement acknowledging requirement to report suspected child abuse. Staff have current mandated reporter training. The staff have expired CPR/First Aid training. The director and staff were advised to take the in-person CPR/First Aid training either through the American Red Cross, American Heart Association, or any Emergency Medical Services Authority (EMSA) approved/accredited training centers. LPA also observed one staff have missing immunization records (Measles and Pertussis). The director was advised to send copies of the immunization records. The director was also reminded to send copies of the documents needed for newly/hired appointed directors. The director was given a copy of the requirements.

Facility Records: Electronic Roster, fire/disaster drills log was completed last February 2, 2024.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394), emergency disaster plan, earthquake preparedness checklist, and California Car Seat Law.

Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

Advisory/Other: First Aid kit boxes were observed with supplies readily available.

LPA observed Sign in and out sheets when dropping off and picking up their child. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. The facility has a daily schedule posted in the director’s office.

Director Kostopoulus was advised of the requirement to report Unusual Incidents. The director was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2024
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: WIND IN THE WILLOWS PRESCHOOL, THE
FACILITY NUMBER: 153801889
VISIT DATE: 05/23/2024
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The director was also reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Director shall permit the Department to inspect the facility, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

No deficiencies were cited during this inspection.



A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The On 8Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Exit interview conducted and a copy of this report, Notice of Site Visit, and appeal rights were provided to Director Ashley Kostopoulus.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
LIC809 (FAS) - (06/04)
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