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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191221770
Report Date: 01/11/2023
Date Signed: 01/11/2023 06:02:23 PM

Document Has Been Signed on 01/11/2023 06:02 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:YMCA OF METRO LA/SANTA CLARITA WILEY CANYONFACILITY NUMBER:
191221770
ADMINISTRATOR:KYLE MITCHELLFACILITY TYPE:
840
ADDRESS:24240 LA GLORITA CIRCLETELEPHONE:
(310) 486-8872
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY: 115TOTAL ENROLLED CHILDREN: 115CENSUS: 5DATE:
01/11/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
05:00 PM
MET WITH:Estefania SanchezTIME COMPLETED:
06:03 PM
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On 1/11/2023 Licensing Program Analyst (LPA)Isabel Ortega conducted an unannounced case management inspection. LPA Ortega met with Teacher, Estefania Sanchez. The purpose of today's inspection is to conduct a case management inspection, and to notify facility there has been a lead exceedance results reporting an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Palmdale Regional Office received notification of water lead exceedance at the facility resulting from a water lead sampling test on 12/13/2022. Based on the records reviewed water outlet (E) has an ALE of 9.2 ppb, water outlet and (F) has an ALE of 11.4 ppb. These areas in the Discovery room and Adventure room have lead exceeding the Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water.

Both water outlets (E) and (F) are only utilized for hand washing and washing other classroom materials and toys. These identified areas on the facility sketch (E) and (F) are not utilized for drinking water nor food preparation. Facility provides filtered water in IGLOOs to fill individual water bottles and one time use disposable cups are provided during day care hours of operation. Children bring their own lunch/ snacks and pre-packed individually packed snacks are also provided by the facility.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
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: YMCA OF METRO LA/SANTA CLARITA WILEY CANYON
FACILITY NUMBER: 191221770
VISIT DATE: 01/11/2023
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During inspection Teacher notified authorized children's representatives of exceedance results and posted notice visible to parents.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiency will being cited. Facility was provided a copy of the appeal rights. An exit interview was conducted with facility Director.

This report shall be made available to the public upon request. The Notice of Site Visit is provided an required to be posted for 30 days. Appeal rights and report have been provided to facility on this day.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023
LIC809 (FAS) - (06/04)
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