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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830628
Report Date: 01/19/2023
Date Signed: 01/19/2023 10:32:51 AM

Document Has Been Signed on 01/19/2023 10:32 AM - 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:OCS HOLY ROSARY ACADEMY PRESCHOOLFACILITY NUMBER:
364830628
ADMINISTRATOR:AUSTIN, CHERYLLFACILITY TYPE:
850
ADDRESS:2620 N. ARROWHEAD AVENUETELEPHONE:
(909) 886-1088
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 44TOTAL ENROLLED CHILDREN: 29CENSUS: 23DATE:
01/19/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Cheryll Austin TIME COMPLETED:
11:00 AM
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On January 19 2023, Licensing Program Analyst (LPA) Zirbes conducted an unannounced case management inspection. LPA Zirbes met with Administrator Cheryll Austin. The purpose of today's inspection is 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 (B) an indoor sink faucet has an ALE of 14.000 ppb.

Per interview with the Administrator, outlet (B) is only utilized for hand washing and the cleaning of the classroom environment, materials and toys. Administrator denied outlet (B) is utilized for drinking water or food preparation. A Brita container filled with safe drinking water and cups is available to preschool children during child care hours. Per Administrator the center is looking into replacing outlet (B).

The facility has notified authorized representatives of this corrective action in both languages English and Spanish.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiency will being cited. Administrator was provided a copy of the appeal rights. An exit interview was conducted with Administrator Cheryll Austin

This report shall be made available to the public upon request. The Notice of Site Visit was provided and is required to be posted for 30 days.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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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