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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 143808560
Report Date: 06/03/2022
Date Signed: 06/03/2022 10:41:54 AM


Document Has Been Signed on 06/03/2022 10:41 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:ICSS - WEST BISHOP STATE PRESCHOOLFACILITY NUMBER:
143808560
ADMINISTRATOR:KAT DUNCANFACILITY TYPE:
850
ADDRESS:164 GRANDVIEW DRIVETELEPHONE:
(760) 873-5123
CITY:BISHOPSTATE: CAZIP CODE:
93514
CAPACITY:24CENSUS: 15DATE:
06/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Peggy LindsayTIME COMPLETED:
10:56 AM
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Licensing Program Analysts (LPA) Justin Dorsey conducted an unannounced Annual Required Inspection at the facility. LPA met with Lead Teacher Kattarina Johnson and Early Learning Program Coordinator Peggy Lindsay and toured the facility indoors and outdoors. Days and hours of operation are Monday - Friday 8:00 AM to 11:30 AM. The preschool consists of one classroom.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, and other hazardous items are made inaccessible to children. LPA's observed the children medications were stored correctly.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment, have cushioning material to absorb falls (sand).

There is a kitchen in the classroom which is made inaccessible to children. AM snack provided for the children. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. LPA observed the facilities smoke detector and fire alarm pull.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ICSS - WEST BISHOP STATE PRESCHOOL
FACILITY NUMBER: 143808560
VISIT DATE: 06/03/2022
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Facility representative was reminded, Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance, transfer or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. 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.
Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility.

All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete LPA reviewed a sample of staff files and observed files were complete. Menus are posted at least one week in advance where an authorized representative can view them.

The facility has an (IMS) policy. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

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.

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.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022
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: ICSS - WEST BISHOP STATE PRESCHOOL
FACILITY NUMBER: 143808560
VISIT DATE: 06/03/2022
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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.


Exit interview conducted, the report was reviewed with Early Learning Program Coordinator Peggy Lindsay . A copy of this report and Appeal Rights were provided. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2022
LIC809 (FAS) - (06/04)
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