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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408508
Report Date: 10/27/2022
Date Signed: 10/27/2022 10:59:34 AM

Document Has Been Signed on 10/27/2022 10:59 AM - 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:SULPHER SPRINGS UNION SCH. DIST.-MINT CANYON PRESCFACILITY NUMBER:
197408508
ADMINISTRATOR:ESCALANTE, JULIEFACILITY TYPE:
850
ADDRESS:16400 SIERRA HIGHWAYTELEPHONE:
(661) 252-8026
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: DATE:
10/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Militza Garcia, Site SupervisorTIME COMPLETED:
11:15 AM
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On 10/27/22, Licensing Program Analysts (LPAs) Villa and Beneroso conducted a Case Management inspection in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPAs Villa and Beneroso met with the Militza Garcia, site supervisor. The purpose of the inspection was disclosed, and entry was granted. Upon arrival, LPAs observed 15 children and 3 staff present.

LPA Beneroso received sample results for the drinking fountain (Sample B) on June 16, 2022. Facility was originally tested on June 11, 2022. Sample B, outdoor drinking fountain had a reading of 5.2 UG/L. Facility ceased use of the outdoor drinking fountain B on June 29, 2022, same day they obtained the results. The outlet was properly covered and put out of service after receiving the results. The program director submitted all documentation required and reported the initial results in a timely manner.

LPA Beneroso received documentation of the facility being replacing the fixture on July 11, 2022. Facility was re-tested on August 15, 2022. The facility received notification the drinking fountain B is safe to be used on August 21, 2022. LPAs observed the water fountains to be in operable conditions since they had been repaired and re-tested.

No citations or deficiencies were issued during this visit.

An exit interview was conducted, and a copy of this report was provided along with a Notice of Site Visit and appeal rights to site supervisor, Militzia Garcia.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2022
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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