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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418587
Report Date: 01/24/2024
Date Signed: 01/24/2024 06:00:46 PM

Document Has Been Signed on 01/24/2024 06:00 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/NORTH VALLEY PRCSFACILITY NUMBER:
197418587
ADMINISTRATOR:OLIVIA REVILLAFACILITY TYPE:
840
ADDRESS:12450 MASON AVENUETELEPHONE:
(818) 425-1728
CITY:PORTER RANCHSTATE: CAZIP CODE:
91326
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 63DATE:
01/24/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Natalie Galstyan, Interim DirectorTIME COMPLETED:
05:47 PM
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On 1/24/2024 Licensing Program Analyst (LPA)Isabel Ortega met with Facility Interim Director, Natalie Galstyan and conducted an Annual Inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA observed 63 children in care and 4 staff providing care and supervision. Facility Operates on North Valley Elementary School campus, the school library and Multi Purpose Room(MPR) are approved for before and after school care.

Facility provides morning and after school care. Monday through Friday from 6:30 a.m. to 8:30 a.m. and after school care from 2:35 p.m. to 6:30 p.m.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed storage for children's belongings. The classroom consists of filtered water dispenser(Brita) with individual disposable cups for children during indoor care. For outdoor children utilize their own water bottles brought from home. An isolation area was inspected, which takes place in library office space. Children have the option for rest time and quiet time if needed.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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/NORTH VALLEY PRCS
FACILITY NUMBER: 197418587
VISIT DATE: 01/24/2024
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Age appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; toilet and sinks are reachable by the children. Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, restocked of toiletries and sanitized by school facility’s on-site custodian. Staff will disinfect the tables before and after snack.

First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers (2A10BC) were observed and in operable condition. Smoke and carbon monoxide tested at 3:00 p.m. and operating according to fire marshal standards. Trash cans with tight lids were observed. The center provides afternoon snack for children enrolled. Snacks are individually pre packaged, properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. The staff room is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every month last drill was conducted and documented on 01/22/2024 at 03:25 p.m. Food allergies are noted and are posted.

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. The playground is well fenced all around, and no bodies of water observed in the outdoor play area.

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

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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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/NORTH VALLEY PRCS
FACILITY NUMBER: 197418587
VISIT DATE: 01/24/2024
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Care and supervision were evaluated and determine basic needs of children are being met. The parent board was reviewed and has all the required forms posted accessible to parents.

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.

Staff are currently certified in Pediatric CPR/First Aid which does not expire until 01/21/2026. Child Care Provider Mandated Reporter(AB1207) training is dated 10/19/2022.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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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/NORTH VALLEY PRCS
FACILITY NUMBER: 197418587
VISIT DATE: 01/24/2024
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All staff are required to take 3-hour Child Care Provider Mandated Reporter 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. All staff 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
For updates on Community Care Licensing.

Per Title 22 Regulations facility is in compliance, no deficiency will be issued today. An exit Interview was conducted with Site Director. 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 posted for 30 days.

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

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC809 (FAS) - (06/04)
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