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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817412
Report Date: 06/29/2023
Date Signed: 06/29/2023 01:44:32 PM

Document Has Been Signed on 06/29/2023 01:44 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:FUNDAMENTALS PRESCHOOL ACADEMY, THEFACILITY NUMBER:
364817412
ADMINISTRATOR:EVELYN CHINCHILLAFACILITY TYPE:
850
ADDRESS:2424 KENDALL DRIVETELEPHONE:
(909) 887-1150
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 19DATE:
06/29/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Evelyn ChinchillaTIME COMPLETED:
12:04 PM
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On June 29, 2023, Licensing Program Analyst (LPA) Maddox conducted an unannounced case management inspection. LPA Maddox met with facility representative Evelyn Chinchilla. The purpose of today's inspection was to conduct a case management inspection, and to notify the facility there has been a lead exceedance referred for an Action Level Exceedance (ALE) of over 5.5 parts per billion (ppb) in the water at the facility.

Palmdale Regional Office received notification of water lead exceedance at the facility resulting from a recent water lead sampling test. Based on the records reviewed, outlet (E), an outdoor drinking fountain (connected to the Preschool) was capped off prior to the water testing and therefore, was not tested. Director stated, unbeknownst to her, the testing agent moved the (E) sticker (previously labeled and attached to the Preschool) to the School age area located in the rear of the center. The water tested inside of the main building used for cooking came back with normal levels. Center utilizes water coolers with disposable cups (and also cups labeled with each child's name) for inside drinking water.

As a result of this inspection, no citation was issued as a result of this inspection. Exit interview conducted, a copy of this report was left with Director, Evelyn Chinchilla.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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