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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418481
Report Date: 08/27/2024
Date Signed: 08/27/2024 03:25:04 PM

Document Has Been Signed on 08/27/2024 03:25 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:PACOIMA CHARTER SCHOOLFACILITY NUMBER:
197418481
ADMINISTRATOR/
DIRECTOR:		FAJARDO, SYLVIAFACILITY TYPE:
850
ADDRESS:11016 NORRIS AVETELEPHONE:
(818) 899-0201
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 72DATE:
08/27/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Angela Tilghman-Paczesmy, Preschool SupervisorTIME VISIT/
INSPECTION COMPLETED:
03:37 PM
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On 8/27/2024 Licensing Program Analyst (LPA), Isabel Ortega met with Angela Tilghman-Paczesmy, Preschool Supervisor and conducted an Annual Random Inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA 72 children in care and 14 staff providing care and supervision. Facility operates in four classrooms referred to as the preschool center.
An isolation area was inspected, which takes place in the main office Nurse room. Children have the option for rest time and quiet time if needed. Parents bring blankets for children and are taken home every Friday for wash. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, restocked of toiletries by staff and on-site Building and Grounds Worker(BGW) disinfects, and sanitizes daily.
The furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and AC ventilation were evaluated. LPA observed individual storage for children's belongings. Facility sampled the water for lead and results are below the 5.5 ppb which is the maximum allowable. Facility provided sample of analysis sample water collected on 12/27/2022 and results for lead were provided on 12/30/2022 with less than 1 ppb. All children bring their own water bottles filled with water from home daily. Facility has extra individual water bottles, disposable cups when needed.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2024
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: PACOIMA CHARTER SCHOOL
FACILITY NUMBER: 197418481
VISIT DATE: 08/27/2024
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Facility operates Monday through Friday from 8:00 a.m. to 3:30 p.m. Extended hours are available in the morning starting at 7:30 a.m. and afternoon until 5:00 p.m. as needed. Part time schedule is also available from 8:00 a.m. to 11:00 a.m. Facility provides children with Breakfast, lunch one snack and a second snack as needed.
Facility has all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, and Earthquake Preparedness Checklist.

First Aid supplies, smoke detectors, carbon monoxide were observed to be operating properly. The fire extinguisher (2A10BC) serviced on 10/15/2023 is reading in green and meets the Fire Marshal codes and standards.

Trash cans with tight lids were observed. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. A refrigerator is adequately equipped, clean, and free from hazards. There is hot running water in the kitchen area.

Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 7/31/2024 at 9:15 a.m. Food allergies are noted and are posted in the food preparation area and in the classroom.

The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair, and age appropriateness. There is adequate shade area for rest.

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

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
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: PACOIMA CHARTER SCHOOL
FACILITY NUMBER: 197418481
VISIT DATE: 08/27/2024
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The playground is well fenced all around, and no bodies of water observed in the outdoor play area. Facility has a staggered schedule for outdoor play.
Facility has three sheds in the play yard utilized for equipment, materials and storage(maintained locked).

The parent board was reviewed and has all the required forms. The snack menu is posted in the main office and parents may request a tangible copy per request.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

Directors is currently certified in Pediatric CPR/First Aid which does not expire until 06/15/2026. Child Care Provider Mandated Reporter (AB1207) training is dated 07/12/2024.
The following Incidental Medical Services (IMS) were discussed.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: PACOIMA CHARTER SCHOOL
FACILITY NUMBER: 197418481
VISIT DATE: 08/27/2024
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Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.
All staff are required to take the Child Care Provider Mandated Reporter (AB1207) training every 2 years. www.mandatedreporterca.com.

Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. According to facility documentation all staff are aware they are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hot-line at (800) 540-4000.



For additional information and forms visit our website at: www.cdss.ca.gov
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: PACOIMA CHARTER SCHOOL
FACILITY NUMBER: 197418481
VISIT DATE: 08/27/2024
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For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

Per Title 22 Regulations facility is complying with rules and regulation, facility is in compliance and no deficiencies will be issued today. An exit Interview was conducted, a copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

A copy of this report must be made available to the public for 3 years. The Notice of site visit shall be visibly posted for 30 days.

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

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5