<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750045
Report Date: 11/29/2023
Date Signed: 11/29/2023 04:06:16 PM

Document Has Been Signed on 11/29/2023 04:06 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:DELPHI ACADEMY PRESCHOOLFACILITY NUMBER:
197750045
ADMINISTRATOR:DANIELLE WOLFSONFACILITY TYPE:
850
ADDRESS:11341 BRAINARD AVETELEPHONE:
(818) 583-1070
CITY:LAKE VIEW TERRACESTATE: CAZIP CODE:
91342
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 32DATE:
11/29/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Danielle Wolfson, DirectorTIME COMPLETED:
04:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On Wednesday, November 29, 2023, at 11:00 a.m., Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with director Danielle Wolfson who guided LPA Rivera on a tour of the facility.

This is a preschool program that serves children ages 2 to 5 years. This program operates Monday to Friday


8:00 a.m. – 4:30 p.m. Sign in and out takes place at the main entrance area by scanning QR code and logging into the app Brightwheel. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and 7 out of 8 present staff are fingerprinted cleared and 4 present staff have current Pediatric First Aid/ CPR certification.

At approximately 11:10 a.m. LPA entered classroom Little Dragon. LPA Rivera observed 12 children getting ready for nap time and staff #4 and staff #5 present supervising the children. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside sink cabinet with a childproof lock making it inaccessible for children to open. LPA Rivera observed a trash bin with a lid.

At approximately 11:19 a.m. LPA entered classroom Mini Dragon. LPA Rivera did not observe any children in the classroom. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside bottom cabinet with a childproof lock making it inaccessible for children to open. LPA Rivera observed a trash bin with a lid.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 8
Document Has Been Signed on 11/29/2023 04:06 PM - It Cannot Be Edited


Created By: Mayra Rivera On 11/29/2023 at 02:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(e)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA Rivera record review and interview with director the licensee did not comply with the section cited above in staff #1 not having either a criminal record clearance or exemption which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2023
Plan of Correction
1
2
3
4
Director Danielle removed and sent home staff #1 and before staff #1 is back on premises, director will is ensure that staff #1 or any new staff must have a clearance and associated to the facility prior to starting.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Mayra Rivera
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023


LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 11/29/2023 04:06 PM - It Cannot Be Edited


Created By: Mayra Rivera On 11/29/2023 at 02:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with Director Danielle, the licensee did not comply with the section cited above in not having the drinking filtered faucets water tested for lead contamination levels which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 12/29/2023
Plan of Correction
1
2
3
4
Director Danielle stated she will contact LA Testing at 714-828-4999 to schedule an appointment to test the drinking faucets by due date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lady King
LICENSING EVALUATOR NAME:Mayra Rivera
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023


LIC809 (FAS) - (06/04)
Page: 3 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045
VISIT DATE: 11/29/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
At approximately 11:28 a.m. LPA entered classroom Junior Dragon. LPA Rivera observed 8 children in circle time with staff #6 present and supervising the children. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside the storage cabinet making it inaccessible for children to reach. LPA Rivera observed a trash bin with a lid.

At approximately 11:37 a.m. LPA entered classroom Big Dragon. LPA Rivera did not observe children inside the classroom. LPA observed the children outside in line for restroom break with staff # 2 present and supervising the children. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside bottom cabinet with a childproof lock making it inaccessible for children to open. LPA Rivera observed a trash bin with a lid.

Heating, lighting, and ventilation were evaluated by LPA Rivera. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostats located in classrooms and temperatures to be 67 degrees. LPA informed director comfortable temperature for children shall be maintained at all times between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C). LPA observed the required 2A10BC fire extinguishers located in the classrooms and hallway and the valve on the green area indicating fully charged and serviced on 12/14/22. Smoke detectors were not tested during this visit due to the detectors being wired to the emergency pull down fire alarm system. Carbon monoxide detectors are located in the classrooms. LPA tested the carbon monoxide in classrooms Mini Dragon, Big Dragon, and Junior Dragon and are operable. The last emergency drill was conducted on 10/30/2023. LPA observed napping equipment cot’s to be in good condition and stored in the classrooms. First aid kit supplies are kept inside the classrooms and LPA observed the kits to be fully equipped. During this visit, per director Danielle, stated currently has no children with medication or severe food allergies. LPA Rivera asked if there were any poisons, firearms, weapons or bodies of water. Director stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Director stated the ill isolation area takes place in the director’s preschool office and children will utilize staff restroom.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
Page: 4 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045
VISIT DATE: 11/29/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Two toilets and one hand washing sink are located in classrooms Little Dragon and Mini Dragon. For classrooms Junior Dragon and Big Dragon the restroom is located in the hallway. LPA Rivera observed the restrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels. LPA observed a total of 7 toilets, 3 urinals and 6 hand washing sinks.

At approximately 11:45 a.m. LPA Rivera entered the outdoor play area. LPA Rivera observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA Rivera observed play structure equipment to be age appropriate and areas around or under high climbing equipment, are cushioned with artificial turf and underneath the turf has a bouncy safety mat that may absorb a fall. Per director the sand is rake weekly. For adequate shade, LPA Rivera observed three sail triangles and an anchored canopy. LPA observed the playground yard to be fenced and the side gates with self-latches and main gates closed and locked with a keypad lock. For outdoor water drinking, children bring out their sippy water bottles.


This program provides a.m., and p.m., snacks and parent provide the lunch. LPA Rivera informed director any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, LPA Rivera observed water pitchers and disposable cups in the classrooms and children water bottles. LPA observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and trash bins with lids that are kept on and in good repair for solid waste. The facility was observed to be free of flies, other insects, and rodents. Lead testing has not been conducted.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and Earthquake Preparedness (LIC 9148). PUB 269 Child Passenger System Poster, and Daily Schedule. LPA Rivera observed sign in/out sheets and observed 32 sign in signatures.

LPA Rivera reviewed the children’s roster, children’s files and staff files.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
Page: 5 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045
VISIT DATE: 11/29/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA Rivera did not observe director Danielle Pediatric First Aid/CPR certification and observed Preventative Health and Safety certification dated 4/21/2018 and has proof of immunization against Pertussis, MMR and Influenza declination. Director has completed the mandated reporter (AB 1207) training dated 11/29/23. Director was informed that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com
Items discussed during this visit:

1. The following items are prohibited by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.



4.LIC 311A - Records to be Maintained at the Facility: LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045
VISIT DATE: 11/29/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination.

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10.Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination.

Director Danielle was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Delphi Academy Preschool did not complete testing prior to their deadline. LPA referred director Danielle to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
Page: 7 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DELPHI ACADEMY PRESCHOOL
FACILITY NUMBER: 197750045
VISIT DATE: 11/29/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Director Danielle was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

The deficiency listed on the following page was observed by the LPA Rivera and is being cited in accordance with California Code of Regulations Title 22 101170(e)- All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC 9224) shall be in each child’s file, acknowledging receipt.

The deficiency listed on the following page was observed by LPA Rivera and is being cited in accordance with California Code of Regulations Health and Safety 1597.16(a)(1) - (1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

Please see attached LIC 809-D for citations. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview conducted and report and appeal rights were reviewed with director Danielle Wolfson.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
Page: 8 of 8