153808741-8-12-2021-12-CC-JTHN-C5U3N5-20210812182321

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153808741
Report Date: 08/12/2021
Date Signed: 08/12/2021 06:23:26 PM

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:	ARVIN STATE PRESCHOOL SIERRA VISTA CAMPUS		FACILITY NUMBER:	153808741
ADMINISTRATOR:	ROSIE MARIE BORQUEZ		FACILITY TYPE:	850
ADDRESS:	300 FRANKLIN STREET		TELEPHONE:	(661) 854-6560
CITY:	ARVIN	STATE: CA	ZIP CODE:	93203
CAPACITY:	24	CENSUS: 5	DATE:	08/12/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Angelica Salinas - Program Director		TIME COMPLETED:	02:05 PM

NARRATIVE

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On 08/06/21 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Program Director Angelica Salinas, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 7:55AM-10:55AM.

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, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. 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. Solid waste storage containers have tight-fitting covers and are in good repair. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. All materials and surfaces 4accessible to children are toxic free. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. Prior to working or volunteering in a licensed childcare facility, all employees are fingerprint cleared through the Department of Education. 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 or at off site activities. The name of the childcare center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. 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 with contact information for authorized representative and or relatives or others who can assume responsibility for the child.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ARVIN STATE PRESCHOOL SIERRA VISTA CAMPUS	FACILITY NUMBER: 153808741
	VISIT DATE: 08/12/2021

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LPA reviewed a sample of staff files and observed files were complete with documentation of meeting qualification requirements and completed mandated reporter training. Menus are posted at least one week in advance where an authorized representative can view them.

There are no children enrolled requiring Incidental Medication Services (IMS). Licensee was advised that should IMS be provided, a plan must be submitted to the Department. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA observed the urinal in the boys' restroom to be inoperable and leaking. LPA also observed there to be patches of dirt on the floor surrounding both toilets in the girls' restroom. Additionally, LPA observed a copious amount of bird feces on the concrete near the westward outdoor entry gate of the preschool.

LPA and Ms. Salinas discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of their appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ARVIN STATE PRESCHOOL SIERRA VISTA CAMPUS	FACILITY NUMBER: 153808741
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/26/2021 Section Cited	1 2 3 4 5 6 7	The child care center shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by LPA's observations. On this date, LPA observed the urinal in the boys' restroom to be inoperable and leaking.
	8 9 10 11 12 13 14	LPA also observed there to be patches of dirt on the floor surrounding both toilets in the girls' restroom. Additionally, LPA observed a copious amount of bird feces on the concrete near the westward outdoor entry gate of the preschool. This poses a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14
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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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

LIC809 (FAS) - (06/04)

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