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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750013
Report Date: 06/12/2023
Date Signed: 06/12/2023 02:54:50 PM

Document Has Been Signed on 06/12/2023 02:54 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:JUST 4 KIDSFACILITY NUMBER:
367750013
ADMINISTRATOR:MORRIS, JENNIFERFACILITY TYPE:
850
ADDRESS:15420 RANCHERO ROADTELEPHONE:
(760) 244-8280
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 50DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Jennifer Morris, DirectorTIME COMPLETED:
03:00 PM
NARRATIVE
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On June 12, 2023, Licensing Program Analyst (LPA), Kuliema Calloway, made an unannounced Inspection to the Just 4 Kids Day Care Center. The purpose of the inspection was to conduct an Annual Random Inspection Visit. LPA met with the Director who granted access and guided LPA on a tour of the facility inside and outside. Upon arrival, there were fifty (50) children in care and twelve (12) staff members. Per Director, the children are inspected (wellness check) for illnesses as they arrive. A review of medication policy indicated that prescription medication (current date) is administered only with parent's written permission. Director and Assistant Director administers medication (inhalers) the documented dosage, date and time are on the LIC 627 forms signed by the parents. For two of the children, the forms were not signed. Medication is properly labeled and stored in its original container. There is a separate area for isolation and care of ill children at the front desk area. Transportation is provided.
Physical Plant: There are four classrooms the left upon entry (A1, A2, A3, and A4) for Kindergarten and Preschool A3 & A4 are a combined classroom and three (3) teachers. There are four classrooms on the right upon entry (B1, B2, B3, and B4) for Preschool with four (4) teachers. Inside play structure (secured, cushion material surrounding). Furniture and equipment were inspected throughout for age appropriateness and good repair. All rooms are clean and safe.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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: JUST 4 KIDS
FACILITY NUMBER: 367750013
VISIT DATE: 06/12/2023
NARRATIVE
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Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings. LPA observed age-appropriate toys, books, and materials throughout the center. Drinking water is available (water fountain in the POD area and Dixie cups). LPA observed enough cots available for napping children. The bedding is stored separately and properly. Per Director the sheets are washed (weekly or as needed) and cots are sanitized daily. There are fire extinguishers (several, observed full), smoke detector and a carbon monoxide detector on the premises.
Sign in and out sheets: For parents is electronic on Bright Wheel APP Program. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Roster current.
Kitchen: clean, fully equipped with refrigerator and freezer (separate staff and center), microwave oven, stove, washer, dryer and storage of food (labelled with expiration date). The facility provides breakfast, AM snack, lunch, PM snack, and evening snack (provided by parent). Menu is posted in the kitchen and on each classroom parent board, front area, and Bright Wheel APP. Allergy list is posted in the kitchen and each classroom. LPA observed an appropriate amount of food and snacks. The chemicals are kept separate from the food (kitchen cabinet).
Bathrooms: observed 2 clean bathrooms (6 toilets, 4 sinks). Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate.
Ratios: Teacher child ratios were observed, and staff names recorded. Care and supervision were observed while teachers interacted with children.
Outside: The facility has 2 playground areas. The preschool play area (right upon exit) gated, separated from older children with grass, sand, and concrete for active play.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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: JUST 4 KIDS
FACILITY NUMBER: 367750013
VISIT DATE: 06/12/2023
NARRATIVE
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Outdoor play equipment slide set, octagon apparatus, tricycles, in good repair. There is a shed (gated and locked-off limits).The area was observed to be free of debris. There is an area for shade and rest. Drinking water is available in the form of a pitcher (Igloo) and Dixie cups and water fountain. School Aged play area (left side) sand and concrete for play was equipped with Basketball court, slide set, octagon apparatus, shade area for rest and is completely fenced. There is a storage shed (gated, locked) off limits. There were no bodies of water on either play area. Children's records and staff records were reviewed. Staff are certified in Pediatric CPR and First Aid. Mandated Reporter training was needed for two staff members. Additional forms and a copy of Title 22 Regulations may be obtained at the department's website www.ccld.ca.gov.
--Director advised visit www.shotsforschool.org for Immunization information.
--Director was informed of responsibility to report suspected Child Abuse, 1-800-827-8724/760-243-6640
--Child Care Centers (Disaster Planning information):https://cccld.childcarevideos.org/child-care-center-operators/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
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:
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
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: JUST 4 KIDS
FACILITY NUMBER: 367750013
VISIT DATE: 06/12/2023
NARRATIVE
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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

There were deficiencies cited during the inspection. See 809 D pages.

An exit interview was conducted, and a copy of this report was read and provided to Jennifer Morris, Site Director at the facility.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 06/12/2023 02:54 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 06/12/2023 at 02:37 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: JUST 4 KIDS
FACILITY NUMBER: 367750013

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on observation, interview, record review, the licensee did not comply with the section cited above in one out of three (S3) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director will provide proof to licensing by POC date 6/16/23.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in two out of three staff which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director will provide proof of training to Licensing by POC date 6/16/23
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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 06/12/2023 02:54 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 06/12/2023 at 02:37 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: JUST 4 KIDS
FACILITY NUMBER: 367750013

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(l)(1)(B)
Personnel Requirements
(B) A copy of the signed LIC 9052 (11/94) shall be kept in the employee's personnel record.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in one out of one staff members (S3) did not have form in files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director will provide proof of the signed form by POC date of 6/16/23 to licensing
Type B
Section Cited
CCR
101221(b)(8)(C)
Child's Records
(C) A signed consent form for emergency medical treatment unless the child's authorized
representative has signed the statement specified in Section 101220(f).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in two out of three children which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director will provide proof of signed form to licensing by POC date 6/16/23.
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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 06/12/2023 02:54 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 06/12/2023 at 02:37 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: JUST 4 KIDS
FACILITY NUMBER: 367750013

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(b)(1)
Personal Rights
(1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in one out of five children which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2023
Plan of Correction
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Director will provide proof of signed form to licensing by POC date of 6/16/23.
Section Cited
Deficient Practice Statement
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2023


LIC809 (FAS) - (06/04)
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