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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750192
Report Date: 09/18/2024
Date Signed: 09/18/2024 03:45:54 PM

Document Has Been Signed on 09/18/2024 03:45 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:CCRC HEADSTART - MIGUEL MONTESFACILITY NUMBER:
197750192
ADMINISTRATOR/
DIRECTOR:		HERMINEH AZIZIANFACILITY TYPE:
860
ADDRESS:10675 TELFAIR STREETTELEPHONE:
(818) 717-4515
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 8DATE:
09/18/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:13 PM
MET WITH:Celia Cassio EECBSTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA's) Maddox and Ortega met with Celia Cassio EECBS for the purpose of conducting an announced pre-licensing/case management inspection. The hours of operation will be: Mon through Friday from 7:00 am to 6:00 pm. Director is requesting to add 9 Toddlers to their licensed Preschool (197414943). With the addition of the toddler component, this license will be converted to a single license.

INDOOR ACTIVITY SPACE:

· The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors


· Floors of all rooms have a surface that is safe and clean (linoleum and carpet).
· A comfortable temperature for children shall always be maintained.
· Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys, and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
· Tables and chairs were present to meet the needs of the children.
· Drinking water is readily available - filtered water
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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 4
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: CCRC HEADSTART - MIGUEL MONTES
FACILITY NUMBER: 197750192
VISIT DATE: 09/18/2024
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·Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children
(locked child proof cabinets).
· There are fully stocked first-aid kit(s) in locations accessible to staff but inaccessible to children:
· The isolation area is located in the office for any child who becomes ill during the day.
· LPA observed operable carbon monoxide detectors and smoke detectors (hard wired), fire extinguishers are located throughout the facility and fully charged.
· The center has a working telephone
· Sign-in and out procedure - manual and Brightwheel sign in
· Staff shall conduct a wellness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
OUTDOOR

LPA observed a shaded rest area for the children (Large umbrellas). Children have safe access to the play yard which is enclosed by a fence to protect children and to keep them in the outdoor activity area (the fencing was taller than 5 ft high). There are no bodies of water present.

The play yard was free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. There was no high climbing equipment on the Toddler play yard, asphalt and artificial turf (padding underneath) was in place along with age appropriate equipment.

Drinking water will be brought out by staff

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CCRC HEADSTART - MIGUEL MONTES
FACILITY NUMBER: 197750192
VISIT DATE: 09/18/2024
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RESTROOMS

LPA observed 1 bathroom with 3 toilets and 3 sinks. All toilets and hand washing facilities were maintained. safe, and sanitary operating condition.

Staff bathroom- there are also 2 separate staff bathrooms available which will also be used as an isolation bathroom.

Measurements taken were as follows:


Room #2 Toddler Room
351/35 = 10

Bathroom:
LPA's observed a changing table within arms reach of a sink and child size toilets.
Outside play space:
1,250/75 = 16

Licensee is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.


POSTINGS:

LPA observed the required forms posted on the Parent Board located in the hallway.

SUPERVISION:

Licensee shall ensure no child is left without the supervision of a teacher at any time, Supervision shall include visual observation.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CCRC HEADSTART - MIGUEL MONTES
FACILITY NUMBER: 197750192
VISIT DATE: 09/18/2024
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NAPPING

· Cots used for napping were maintained in a safe condition.


· Each cot/mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child.
· LPA informed Director Cots or mats should be wiped with a detergent/disinfectant weekly or when soiled or wet.
· Bedding will be stored individually so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding (individual cubbies).
· Napping equipment shall be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children.

LEAD TESTING -

Director states the building was tested for lead in 2023.

Fire Clearance has been received for the requested capacity of 30 children (10 Toddlers and 20 PS).


An exit interview was conducted with the above items discussed and a copy of this report was provided to the Licensee. Toddler Option will be approved and incorporated as a result of this inspection.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
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