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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815208
Report Date: 09/01/2022
Date Signed: 09/01/2022 03:46:23 PM

Document Has Been Signed on 09/01/2022 03:46 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MC DONALD LEARNING CENTERFACILITY NUMBER:
364815208
ADMINISTRATOR:LILIA VOLLAIREFACILITY TYPE:
830
ADDRESS:1017 HOLDEN AVENUETELEPHONE:
(909) 585-6848
CITY:BIG BEAR CITYSTATE: CAZIP CODE:
92314
CAPACITY: 8TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
09/01/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Facility Representative, Lisa Burtner TIME COMPLETED:
04:00 PM
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On September 1, 2022 Licensing Program Analyst (LPA) Zirbes met with the Facility Representative, Lisa Burtner. The purpose of the inspection was to conduct an unannounced required one year inspection. During the inspection, LPA toured and inspected the Infant program in accordance with the facility sketch. LPA observed a total of six infants, one teacher and one aide providing supervision at the time of the inspection. The infant area consists of two rooms. One room is a dedicated sleeping and diaper changing area and the other room is an activity/play/eating area. In addition there is an outdoor play space. The center also operates an School Age Program (#364840540) and Preschool Program (#364815206). The center operates 7:00am -6:00pm, Monday through Friday.
Indoor/Children's Area: Indoor activity space for infants is physically separate from space used by children in the preschool and school-age child care center components. Infant center is equipped with appropriate furniture and equipment, changing table and feeding chairs. Furniture is maintained in good repair and safe condition (age appropriate). LPA did not observe sharp points or edges, or small parts that could be swallowed. Per staff interviews equipment, toys and furniture are sanitized daily. There is one hand washing sink within arms length of the changing table. No infant is left without supervision (visual), nor left unattended. At the time of this inspection, the facility was in compliance with the staff/infant ratio and is not exceeding the approved capacity for the facility.
Furniture and equipment were inspected for age appropriateness and good repair. Based on LPAs observations the toys and equipment were in good repair at the time of this inspection. LPA observed staff interaction with the infants during free play, naps, and observed staff read a book and sing with the infants. There is a Infant Daily Report which documents the times the infant napped, time of diaper changing and what the infant ate. Report is completed each day by the staff. Used diapers are put in a diaper genie which is stored near the changing area. Each infant has container labeled with their name for the storage of personal items.

Report continued on page two

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815208
VISIT DATE: 09/01/2022
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Report continued from page three

Food Service: There is a small refrigerator, microwave and storage area in the infant room. The area appeared clean and sanitary at the time of this inspection. The parents provide all food for the infants. LPA observed the food and milk was labeled and dated.

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 licensed-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.

LPA reviewed with Administrator the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.



LPA discussed the safe sleep regulations with Administrator and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Administrator of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 five

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815208
VISIT DATE: 09/01/2022
NARRATIVE
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Report continued from page one

LPA observed the cleaning compounds were stored on a high shelf inaccessible above the sink. Additional cleaning supplies and maintenance materials for the center are stored in a locked shed on the Center property. The infant center does not have a fire place. The building has central heating. The building does not have air conditioning however has ceiling fans in the room. The room temperature was comfortable at the time of this inspection. LPA observed the carbon monoxide, Fire Extinguisher and smoke detector in working condition. There is a working telephone on the premises. There is an isolation room for ill children. The first aid kit was inspected and based on LPA observation the first aid kit contained all required documentation. The first-aid manual within the first aid kit was dated 2011, LPA advised the Center to obtain a current edition of the first aid manual. The facility maintains electronic sign in and out records. Based on LPA review the sign in/out sheets were current and accurate.

No smoking is allowed on the premises. LPA did not observe baby walkers or other prohibited play equipment on the premises.

Children/Infant are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription and non prescription medication are administered only with parent's written permission and a doctor's note. Staff document when the medication is administered. All prescription medication is stored in the staff office.

Napping: LPA observed cribs and cots in the infant sleeping area. The crib mattress were covered in vinyl or similar moisture-resistent material, and were appropriate to the size of the cribs. LPA observed tape had been placed over tears in the vinyl material covering the crib mattress. LPA advised the Center to replace the crib mattress as they are showing signs of wear. While LPA was in the infant sleeping area, LPA observed Child 1 (C1) an infant under 12 months was sleeping on their stomach inside a crib for approximately 15 minutes. Staff 1 (S1) was providing supervision at the time and did not return C1 to their back for sleeping. C1 did not have a LIC 9227 on file. Based on LPA observation, the staff failed to return C1 to their back for sleeping, which poses a immediate risk, this resulted in a Type A citation refer to LIC 809D.
Report continued on page three
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815208
VISIT DATE: 09/01/2022
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Report continued from page two

Outdoor: Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. The outdoor play area is enclosed by a wooden fence. LPA observed age appropriate equipment cars, sand toys and a Little Tikes climbing structure placed on sand. The climbing structure was secured to the ground. An umbrella was present to provide a shaded rest area. The teachers take water and cups to the outdoor play space for the infants. Based on LPA observation the outdoor play area was in good repair at the time of this inspection.

Infant File Review: LPA reviewed a total of 10 infant files. Two of the ten infant files were missing documentation of the physicians report, a technical advisory notice was provided. All 10 files were missing documentation if the 15 minute checks. This is a potential risk to the children in care and resulted in a type B citation. LPA reviewed five infant files for children under 12 months of age. All five files did not contain a Infant Safe Sleep Plan (LIC 9227). This is a potential risk to the children in care and resulted in a type B citation.

Per conversation with the facility representative, and record review the last disaster drill was conducted in July 2022.

Staff Files: LPA reviewed a total of four staff files. Based on LPA's review at the time of the inspection the Center did not have at least one staff member who had an in person pediatric CPR and pediatric first aid certification. All staff present had current online CPR/First aid training which did not meet the Health and Safety Code. This is a potential risk to the children in care and resulted in a type B citation.
Facility Records: LPA observed the Roster to be complete and current.
Posting Requirements: Center has required posting posted (license, PUB 393, LIC610, car seat law information). LPA observed Licensing and Parent boards to be incompliance including the required posting.

Report continued on page four
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815208
VISIT DATE: 09/01/2022
NARRATIVE
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Report continued from page four

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

Licensee 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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The licensee/Applicant shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family 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.


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.

Report continued on page six

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/01/2022 03:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/01/2022 at 02:10 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: 364815208

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101429(a)(2)(B)(3)(a)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: (3) Infants up to 12 months of age who are sleeping in a position other than on their back. (a) If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, staff shall return the infant to their back for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on LPA observation, interview and record review, the licensee did not comply with the section cited above in when Child 1 (C1) an infant under 12 months was observed by LPA to be sleeping on their stomach inside a crib for approximately 15 minutes. Staff 1 (S1) did not return C1 to their back for sleeping. C1 did not have a LIC 9227 on file. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/02/2022
Plan of Correction
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During the inspection, the staff member was advised to return an infant to their back for sleeping. All staff will receive a refresher training regarding safe sleep practices to ensure 15 minute checks are being completed and an infant is not sleeping on their stomach unless Section C of the 9227 is completed and in the child's file. Staff training will take place by close of business 9/2/22 and documentation will be submitted to CCL verifying the training.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022


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Document Has Been Signed on 09/01/2022 03:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/01/2022 at 02:10 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: 364815208

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review, the licensee did not comply with the section cited above when at the time of the inspection the Center did not have at least one staff member who had an in-person pediatric CPR and pediatric first aid certification. All staff present had current online CPR/First aid training which did not meet the Health and Safety Code. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/22/2022
Plan of Correction
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Staff will attend an in person CPR/First aid class. Center will devise a plan to ensure there is always one person on site who meets the regulation.
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in five of five infant files for children under 12 months of age did not contain a completed Infant Safe Sleep Plan (LIC 9227) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/09/2022
Plan of Correction
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Per facility representative, all parents will be provided with the document to complete. A copy of the document will be placed the child's file by 9/9/22. The LIC 9227 will be added to the enrolment packet for each infant under 12 months old.
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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022


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Document Has Been Signed on 09/01/2022 03:46 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/01/2022 at 02:10 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: 364815208

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(C)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 10 of 10 infant files reviewed were missing documentation of the 15 minute checks which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/06/2022
Plan of Correction
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2
3
4
Per facility representative, a document will be developed to ensure the 15 minute checks are being documented according to the regulations. A copy of the form will be submitted to CCL. The center will complete a staff training by 9/16/22.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022


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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MC DONALD LEARNING CENTER
FACILITY NUMBER: 364815208
VISIT DATE: 09/01/2022
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Report continued from page five

Based on LPA observations, staff interviews and file review, citations were issued during the inspection today regarding incomplete child and staff files and care and supervision. Refer to LIC 809D for further information.

LPA Zirbes informed facility representative Lisa Burtner that this report dated September 1, 2022, documents one Type A citation, which shall be posted for 30 consecutive days as there are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Zirbes informed the facility representative Lisa Burtner to provide a copy of this licensing report dated September 1, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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