364830628-9-26-2023-12-CC-KZIS-CW2UHG-20230926153554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830628
Report Date: 09/26/2023
Date Signed: 09/26/2023 03:36:03 PM

Document Has Been Signed on 09/26/2023 03:36 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:	OCS HOLY ROSARY ACADEMY PRESCHOOL		FACILITY NUMBER:	364830628
ADMINISTRATOR:	AUSTIN, CHERYLL		FACILITY TYPE:	850
ADDRESS:	2620 N. ARROWHEAD AVENUE		TELEPHONE:	(909) 886-1088
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92405
CAPACITY: 44	TOTAL ENROLLED CHILDREN: 20	CENSUS: 17	DATE:	09/26/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Administrator		TIME COMPLETED:	03:45 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	On September 26, 2023, at 12:30 p.m. Licensing Program Analyst (LPA) Kendal Zirbes met with Administrator Cheryll Austin. The purpose of the inspection was to conduct a required one year inspection at the licensed facility. LPA disclosed the purpose of the inspection to the Facility. Present during today’s inspection were 17 preschool age children, four teachers and administrative staff. Indoor/Children's Area: The preschool program is operated out of two classroom (Cubs and Explorers) on OCS Holy Rosary Academy. The facility operates 7:00a.m. to 6:00 p.m, Monday to Friday. Child care center 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 a the classrooms and in the staff kitchen. The cleaning products in the classrooms were stored in cabinets equipped with locks/latches, and were inaccessible. 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 classroom had tables and chairs to meet children’s needs. LPA observed the classroom had areas for dramatic play, art, writing, manipulates, and a library. 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 personal water bottles labeled with the child's name. All materials and surfaces are toxic free, window screens in good repair and free of debris. There are carbon monoxide detectors, smoke detectors and Fire Extinguisher in the Center. Restroom: An approved waiver is on file regarding the bathroom. The preschool students utilize the elementary girls bathroom. The bathroom was equipped with five toilets and five sinks. 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: 09/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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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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: OCS HOLY ROSARY ACADEMY PRESCHOOL	FACILITY NUMBER: 364830628
	VISIT DATE: 09/26/2023

NARRATIVE

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There was working telephone service in the Center. There is an isolation area for children who become ill. The isolation area is located within the administrative office located in the main office of the school. The facility maintains a comfortable temperature at all times. 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 by the families and two snacks are provided by the school.

Napping
LPA observed the children napping during this inspection. The children were napping on individual cots.

Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The area has one large play structure, and swings. There was cushioning material under the climbing structure and swings. The swings and climbing structure were securely anchored to the ground. The area was observed to be free of debris at the time of this inspection. Drinking water is readily available for the children when outdoors via personal water bottles. An approved waiver was on file regarding the outdoor space.

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
At the time of this inspection, zero medications were being administrated or stored for the preschool students.

Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: OCS HOLY ROSARY ACADEMY PRESCHOOL	FACILITY NUMBER: 364830628
	VISIT DATE: 09/26/2023

NARRATIVE

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Report continued from page two
Child/Personnel Records
LPA reviewed five child record and five personnel files during this inspection. Based on LPA review, three personnel files were incomplete and did not contain the required documentation. Staff 2, Staff 3 and Staff 5 were missing documentation of the required immunization's (Pertussis, Influenza, Measles and TB). In addition based on LPA review, the CPR/First Aid training for the preschool staff expired in 8/2022. Therefore, zero staff members were on site with a current CPR/First Aid training. Two type B citations were issued regarding the Personnel records, refer to LIC 809D. Child files were complete and contained all required documentation.

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 May 2023). LPA advised the Center to post the results for the required Lead testing.
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.
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: 09/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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: OCS HOLY ROSARY ACADEMY PRESCHOOL	FACILITY NUMBER: 364830628
	VISIT DATE: 09/26/2023

NARRATIVE

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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 (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/inspection-process.

Based on LPA record review, two type B citations were issued regarding the personnel records. Refer to LIC 809D.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the facility representative Cheryll Austin.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/26/2023 03:36 PM - It Cannot Be Edited

Created By: Kendal Zirbes On 09/26/2023 at 03:01 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: OCS HOLY ROSARY ACADEMY PRESCHOOL	FACILITY NUMBER: 364830628
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/26/2023

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above when zero staff members were on site with a current CPR/First Aid training. The CPR/First Aid training expired in 8/2022. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/09/2023
	Plan of Correction
1 2 3 4	Per Administrator, a CPR/First Aid training is scheduled for the staff on October 6, 2023. Documentation that the training was completed will be submitted to the Department.

Type B

Section Cited

CCR

101217(a)

Personnel Records

(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: 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 three of five personnel records were missing documentation of the required immunization's, and one teacher file was missing documentation of their education, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/09/2023
	Plan of Correction
1 2 3 4	Per Administrator, personnel files will be reviewed to ensure all required documentation is included. Documentation will be submitted to the Department showing the documentation has been added to the personnel files.

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: 09/26/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

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