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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815206
Report Date: 11/22/2022
Date Signed: 11/22/2022 05:31:35 PM

Document Has Been Signed on 11/22/2022 05:31 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:MC DONALD LEARNING CENTERFACILITY NUMBER:
364815206
ADMINISTRATOR:LILIA VOLLAIREFACILITY TYPE:
850
ADDRESS:1017 HOLDEN AVENUETELEPHONE:
(909) 585-6848
CITY:BIG BEAR CITYSTATE: CAZIP CODE:
92314
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 31DATE:
11/22/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:31 PM
MET WITH:Licensee Lisa Burtner TIME COMPLETED:
05:40 PM
NARRATIVE
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On November 22, 2022, Licensing Program Analyst (LPA) Zirbes conducted an unannounced Case Management - Deficiencies inspection. LPA met with facility representative Lisa Burtner. At the time of the inspection there were 31 preschool age children present.

During the course of a complaint investigation, LPA conducted interviews with staff and parents. In addition, LPA conducted a review of the facility files. Based on record review, interviews and LPA observation, Staff 1 was categorized as a preschool teacher during the unannounced complaint inspection conducted on October 26, 2022. During the inspection on October 26, 2022, LPA observed S1 alone and providing supervision to preschool children in the Zebra classroom. Confidential interviews confirmed S1 and staff 2 (S2) have been left alone in a classroom with preschool age children. LPAs record review of S1 and S2s file documented that S1 and S2 have three Early Childhood Education (ECE) units and are currently enrolled in additional ECE units. Therefore, currently S1 and S2 qualify as teacher’s aide and not as a teacher and therefore shall work only under the direct supervision of a teacher. Therefore, a type A citation was issued for California Code of Regulations, Title 22, Division 12 Chapter 1 101216.1 (b)(1) Teacher Qualifications and Duties.
Furthermore, based on interviews conducted and record review, the facility staff notified child 1 (C1) authorized representatives of the unusual incident that occurred on October 21, 2022. However, the facility failed to report the unusual incident to the Department within the required timeframe. Over the investigation the Department was made aware that C1 had regularly hit his/her head on objects in the classroom. This unusual incident may have threatened the physical or emotional health or safety of C1 and should have been reported. Therefore, a type B citation was issued for California Code of Regulations, Title 22, Division 12 Chapter 1, 101212 (d) Reporting Requirements.
In addition, during LPAs staff file review, which was conducted on October 26, 2022, LPA observed S1 had been employed at the Center since June 2021. However, S1 did not have the Measles, Mumps and Rubella immunization. Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815206
VISIT DATE: 11/22/2022
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Report continued from page two

The facility was provided with a technical violation for Health and Safety Code 1596.7995 (a)(1) Employees or volunteers at day care center; immunization requirements; records; exemptions.
Refer to the attached 809D.

In addition, each report (documenting a Type A citation- that pose an immediate Health and Safety risk to children in care) shall remain posted for 30 days along with the Notice of Site Visit, Parents of any currently enrolled children and any newly enrolled children for the following 12 months shall sign form LIC 9224 (Acknowledgment of Receipt of Licensing Reports), a copy shall be kept in each child’s file. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty for each child’s parent who did not sign the LIC 9224 (Acknowledgment of Receipt of Licensing Reports).


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, Lisa Burtner.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
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Document Has Been Signed on 11/22/2022 05:31 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 11/22/2022 at 03:16 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: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815206

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/23/2022
Section Cited
CCR
101216.1(b)(1)

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101216.1 (b)(1) Teacher Qualifications and Duties: A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1)……Credentialing. This requirement was not met as evidence by:
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Per Facility representative aides will not be left alone and children will be with a qualified teacher at all times.
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Based on record review, observation and interviews S1 and S2 have three ECE units and qualify as teachers aids, not as teachers. S1 and S2 must be under the direct supervision of a teacher. This poses an immediate risk to the health and safety of persons in care.
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Type B
12/15/2022
Section Cited
CCR101212(d)

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101212 (d) Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) ... a report shall be made to the Department... within seven days following the occurrence of such event. This requirement is not met as evidence by:
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Per facility representative the Center will report any unusual incident within the required timeframe and document within the child files. A training will be provided to staff regarding reporting requirements. Copy of training will be submitted to Licensing
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Based on record review, on October 21, 2022, an unusual incident occurred at the Center. The facility failed to report the unusual incident to the Department. This poses a potential risk to the health and safety of persons in care.
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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:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2022


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