153801420-12-12-2023-12-CC-BBEO-CYFMBZ-20231212082846

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153801420
Report Date: 12/11/2023
Date Signed: 12/12/2023 08:29:14 AM

Document Has Been Signed on 12/12/2023 08:29 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:	ARVIN STATE PRESCHOOL		FACILITY NUMBER:	153801420
ADMINISTRATOR:	MAGDALENA HERNANDEZ		FACILITY TYPE:	850
ADDRESS:	633 WALNUT DRIVE		TELEPHONE:	(661) 854-6580
CITY:	ARVIN	STATE: CA	ZIP CODE:	93203
CAPACITY:	48	CENSUS: 13	DATE:	12/11/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Ms. Salinas		TIME COMPLETED:	01:50 PM

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On 12/11/2023, Licensing Program Analyst (LPA) Beneroso met with the facility’s Site Supervisor, Ms. Salinas for the One Year Required inspection for the preschool license in accordance with the facility sketch. A tour of the facility was conducted of the classroom and outdoor space areas. Upon arrival, LPA observed 13 preschool age children present children and 3 staff members on the premises providing care and supervision. The hours of operation are 7:55:AM - 10:55AM and 11:30AM to 2:30PM Monday - Friday. Incidental Medical Services (IMS) were discussed.

Indoor/Children’s Area:

There is currently one classroom operating in the facility. The room we observed to be clean, sanitary; floors of all rooms have a surface that is safe and clean. There cleaning compounds are made inaccessible, they are located in the classroom in an upper cabinet, in a closet. Furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with name) for his/her clothing, and personal belongings. There is an assigned area for sick/ill in the school’s nurse’s office. All indoor passageways, stair ways, incline, ramps, open porches, and other areas of potential hazard are kept free of obstruction. There is a working telephone on the premises. Facility maintains a comfortable temperature at all times.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023

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: ARVIN STATE PRESCHOOL	FACILITY NUMBER: 153801420
	VISIT DATE: 12/11/2023

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Children/Personnel Records: Site Supervisor and Staff qualifications were verified. Children’s files were also observed to be complete.

Facility Records: Roster, sign in and out sheets and fire/disaster drill log (completed on 09/14/2023) were also observed to be maintained as required.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394L), emergency disaster plan, earthquake preparedness checklist.

Advisory/Other: The First Aid kits were observed in each classroom and were observed complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. CPR/First Aid is maintained current. Mandated Reporter Training is maintained current, it expires on 08/24/2025. Electrical outlets are inaccessible, recalled and or prohibited toys or play equipment were not observed on the premises. There are no window cords accessible to children. No Smoking prohibited on the premises, daily inspection for illness, no prohibited childcare items observed. Firearms/weapons are not allowed or stored on premises.

Site Supervisor was advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624 when submitting the report to the department (email address on the website: www.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 the Child Care 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

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023

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: ARVIN STATE PRESCHOOL	FACILITY NUMBER: 153801420
	VISIT DATE: 12/11/2023

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Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors. Drinking water is available inside the center, water dispenser was observed. Outdoor water is provided in the form of filtered used to fill personal water bottles. There is working Carbon monoxide detector, smoke detector and Fire Extinguishers in the classroom (2A10BC) in operable conditions.

Teacher child ratios were observed to be appropriate, and staff names recorded. Care and supervision were evaluated to determine if the basic needs of children are met and are appropriate.

Health Related Services/IMS: This facility does not currently provide Incidental Medical Services – IMS. 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/childquanda.htm

Food Service: The facility offers Breakfast, AM Snack for the AM Shift and Lunch, PM Snack for the PM snack. The meals are provided by the school cafeteria.

Restrooms: LPA inspected and observed one restroom with 3 toilets that were in operable condition. LPA observed second bathrooms to have soap, toilet paper and paper towels readily available. Water temperature is appropriate.

Napping: Children do nap in the facility since is a half day program.

Outdoor: The facility has one playground/outdoor areas for the children. All outdoor and indoor passageways, stair ways, incline, ramps, open porches, and other areas of potential hazard are kept free of obstruction; Outside play area is completely fenced. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. There is grass and concrete surface areas for active play. The area was observed to be free of debris, free from hazard, holes, broken items, debris, cushioning material underneath. No bodies of water were observed. There are areas for shade and rest.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023

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: ARVIN STATE PRESCHOOL	FACILITY NUMBER: 153801420
	VISIT DATE: 12/11/2023

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Site Supervisor 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.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe. Applicant was advised that all LIC forms can be found at: https://www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list/i-l

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Site Supervisor 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 childcare center 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.

There were no citations issued during this visit. Exit interview conducted and report was reviewed with Site Supervisor, Angelica Salinas. A copy of this report was provided electronically along with her appeal rights and Notice of Site Visit. A notice of site visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara Beneroso	TELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023

LIC809 (FAS) - (06/04)

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