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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364806900
Report Date: 11/02/2022
Date Signed: 11/02/2022 02:35:09 PM

Document Has Been Signed on 11/02/2022 02:35 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:SBCUSD-ABRAHAM LINCOLN ELEMENTARY SCHOOLFACILITY NUMBER:
364806900
ADMINISTRATOR:LATASHIA KELLYFACILITY TYPE:
850
ADDRESS:255 W. 13TH STREETTELEPHONE:
(909) 388-6370
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 59TOTAL ENROLLED CHILDREN: 42CENSUS: 15DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Facility Representative Mariana Verdugo TIME COMPLETED:
01:00 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
Licensing Program Analyst (LPA) Zirbes met with the Facility Representative Mariana Verdugo for the purpose of conducting an unannounced required one year inspection. LPA toured and inspected the facility in accordance with the facility sketch. There were 15 preschool age children, two teachers and three aides on the premises when LPA arrived. Based on LPAs observation the facility was meeting the capacity/ratio requirements during this inspection. The preschool program is operated out of two modulars located on Lincoln Elementary School campus. The facility operates two session each day an AM session, 8:00 AM - 11:00 AM and a PM session 12:00 PM - 3:00 PM.
Indoor/Children's Area:
Child care enter was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in upper cabinets equipped with key locks. Therefore the cleaning products were inaccessible to the children in care. Zero poisons are stored in the classroom. LPA observed the furniture/equipment is in good condition. Classroom was free of flies, other insects, rodents. The classrooms had tables and chairs to meet children’s needs. LPA observed the classrooms had designated areas for writing, manipulates, dramatic play, art, and computer area. In addition, there was a carpet area for story time/instructional area. Children's belongings are kept in cubbies labeled with the children's names. Trash cans for solid waste have tight fitting lids. Drinking water is readily available indoors via a water fountains and bottled water. All materials and surfaces are toxic free, window screens in good repair and free of debris. There is a working Carbon monoxide detectors, smoke detector and two Fire Extinguisher (3A40BC) which met the State Fire Marshals standards. There are two bathrooms located within each classroom each equipped with a toilet and sink. Bathrooms were equipped with a door and a curtain for individual privacy. Bathrooms were observed to be in safe and sanitary operating condition. Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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 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: SBCUSD-ABRAHAM LINCOLN ELEMENTARY SCHOOL
FACILITY NUMBER: 364806900
VISIT DATE: 11/02/2022
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
Report continued from page one

There was working telephone service within the classrooms. There is an isolation area for children who become ill. The isolation area is located within the classroom and the child is separated from the other children. The facility maintains a comfortable temperature at all times, first aid supplies were located in the classrooms. LPA observed the centers electronic sign in/out sheets, which are completed daily. Smoking is prohibited on the premises. LPA did not observe prohibited childcare items during this inspection.

Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises. Meals are provided through the schools food program.

Napping
The preschool program only offers a half day program. Therefore, the children do not nap at the facility. The classroom has a designated areas for relaxation and quite play.

Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The area has one large play structure, tricycles, balls and benches. The large play structure was placed on cushioning material and was securely anchored to the ground. The area was observed to be free of debris at the time of this inspection.

Health Related Services
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

Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
Page: 2 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: SBCUSD-ABRAHAM LINCOLN ELEMENTARY SCHOOL
FACILITY NUMBER: 364806900
VISIT DATE: 11/02/2022
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
Report continued from page two

Staff/Personnel Records
LPA reviewed nine child record and six staff files during this inspection. Based on LPAs review all child files contained the required documentation. Based on LPAs review of the staff files, LPA found that one of six staff files did not contain documentation that the staff member competed the required mandated reporter training. Per LPAs conversation with the staff member the training had not been completed. A technical advisory notice was provided.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed a current roster, disaster drill log (last drill 10/2022), current CPR/First Aid with expiration date of 2/09/23 and current mandated reporter training which expires 9/29/2023.

Posting Requirements
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393), menu, car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist. LPA reminded the center representative that failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. .

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Center shall permit the Department to inspect the child care center and to privately interview children or staff, to determine compliance with or to prevent violations of child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Report continued on page four

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
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: SBCUSD-ABRAHAM LINCOLN ELEMENTARY SCHOOL
FACILITY NUMBER: 364806900
VISIT DATE: 11/02/2022
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
Report continued from page three

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Based on LPA record review one technical advisory notice was issued during this inspection regarding staff files.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative Mariana Verdugo .

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5