153808909-7-7-2022-12-CC-EROZ-CG4VLT-20220707163227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153808909
Report Date: 07/01/2022
Date Signed: 07/07/2022 04:32:33 PM

Document Has Been Signed on 07/07/2022 04:32 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	MAOF ARVIN EARLY LEARNING CENTER		FACILITY NUMBER:	153808909
ADMINISTRATOR:	GLORIA WILLIAMS		FACILITY TYPE:	850
ADDRESS:	800 SOUTH A STREET		TELEPHONE:	(661) 854-3640
CITY:	ARVIN	STATE: CA	ZIP CODE:	93203
CAPACITY:	46	CENSUS: 28	DATE:	07/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:27 AM
MET WITH:	Laura Flores, Site Supervisor		TIME COMPLETED:	03:38 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 07/01/22 at 10:27 a.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced Annual Required inspection at the MAOF Arvin Early Learning Center facility to assess the Center's operation of their Program and current physical plant status. And to evaluate the Center's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. The LPA met with the Site Supervisor, Laura Flores and stated the purpose for the inspection and provided a copy of the Entrance Checklist form, LIC 125. Site Supervisor provided copy of the Child Care Center children roster (LIC 9040) and Personnel Report (LIC 500). The Center maintains on file a current Designation of Facility Responsibility (LIC 308), Sign in and Sign Out Rosters, current Parent Handbook. At 11:05 a.m. LPA Rodriguez along with the Director conducted a walk trough of the inside and outside of the Facility along with the entire operation of the facility/center program. The facility license is posted on a prominent place of the Center. During the walk through/inspection of the Facility the LPA discussed observations of Title 22 requirements. The Center is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. First aid kits are available and complete (inaccessible to children/infants.) The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Center conducts and records emergency disaster drills. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children. Furniture and equipment were inspected for age appropriate and observed to be in good repair and defects free. Sign in/out rosters, telephone service, heating, lighting and ventilation were evaluated and no defects were noted. There are clean safe and sanitary individual space/cubbies with children's names. The facility utilizes a designated isolated area to isolate ill children.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

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: MAOF ARVIN EARLY LEARNING CENTER	FACILITY NUMBER: 153808909
	VISIT DATE: 07/01/2022

NARRATIVE

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be limited to any physical plant addition.

Regarding COVID-19, the LPA advised the Director that Licensees and providers should continue to follow COVID-19 requirements and guidance in all applicable CDSS Providers Information Notices (PINs) and All County Information Notices (ACINs), in addition to guidance or instructions from health care providers, Centers for Disease Control and Prevention (CDC), CDPH, Department of Developmental Services (DDS), Cal/OSHA, and local public health departments, as applicable to the particular facility or home category. If there are differing requirements between the most current CDC, CDPH, CDSS, DDS, Cal/OSHA, and local health department guidance or health orders, licensees and providers should follow the strictest requirements.

The LPA provided information regarding where to locate Information Provider Notices (PINs) Training (e.g. Mandated Reporter) and how to access and subscribe to Child Care Licensing Quarterly Updates. The LPA advise Ms. Flores Director to continue to become familiar with the Guardian Background Check Program and with the Regulatory Enforcement (CARE) Tools processes, to visit the Departments Website at www.ccl.ca.gov at least on a weekly basis to obtain the most current Child Care information. And Information Provider Notices (PINs) specially PIN 22-02-CCP (Best Practices Related to the provision of Incidental Medical Services) and PIN 20-24-CCP Recently Approved Safe Sleep regulations.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care. Therefore, no deficiencies were cited. Overall, the Center is in compliance per Title 22 regulations, no deficiencies cited during this inspection.

An exit Interview was conducted and a copy of this Report, Children's Record Review form, LIC 857, Review of Staff Records form, LIC 859, Notice of Site Visit, LIC 9213 were provided to Ms. Flores.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

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: MAOF ARVIN EARLY LEARNING CENTER	FACILITY NUMBER: 153808909
	VISIT DATE: 07/01/2022

NARRATIVE

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The toys and material use for instructions meet regulatory requirements. The trash cans contain tight lids. All toilets, hand washing, and bathing facilities are in safe and sanitary operating condition..

The outdoor play areas were noted free of hazards. Playground items are properly secure and free of loose or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Climbing structures are age appropriate, play equipment is properly securely and anchored with adequate resilient. There is cushioning material underneath and around the inside and outside play areas. On the outside play area, there is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed.

LPA observed staff providing care and supervision children. The Staff monitors food intake and/or special diets; provides toileting and dressing assistance if needed, and assist in other personal hygiene needs; etc. At no time the LPA observed no child being unsupervised. The LPA advise the Site Supervisor to ensure every one working at the center is current in all required training and properly qualified to provide quality care and safe supervision to children in care.

The facility is licensed to provide child care services and education to, up to, 46 children ages two to six years old, and may accept up to 5 non-ambulatory children. Currently there are 15 children present in care. The Center Supervisor indicated she ensures the facility does not go over the capacity specified on the license.

The LPA conducted a review of several Staff records. The review included, but was not limited to the following: Criminal record statements (LIC 508) Record of submission of Child Abuse Index Checks. Staff qualification. Reference letters and verifying work experience on file. Health clearances, including TB clearances. Pediatric CPR/first aid cards for designated staff. 15 hours of health & safety training for designated Staff. Notice of Employee Rights receipts (LIC 9052). Statement Acknowledging Requirement to Report Suspected Child Abuse. (LIC 9108) and Mandated Reporter Training certificate. Copy of driver’s license. Personnel Record (LIC 501) or application/resume with required information.

A review of staff records on today's date indicates that the Center staff and other individuals listed on the LIC 500, Personnel Report and other personnel working at the Facility have received Criminal Record, FBI, DOJ

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

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: MAOF ARVIN EARLY LEARNING CENTER	FACILITY NUMBER: 153808909
	VISIT DATE: 07/01/2022

NARRATIVE

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and Child Abuse Central Index Check clearances or exemptions.

Also, a review of several Children records was conducted. The review included, but was not limited to the following: Admission agreements. Needs and Services Plans for infants,. Immunization Records (“blue cards; PM 286) for non-school-age children. Authorizations for dispensing medications signed by parents. Identification and Emergency Information forms (LIC 700) Child’s Pre-admission Health History- Parents’ Report forms (LIC 702) Child’s Pre-admission Health Evaluations- Physician’s Report forms (LIC 701)
Documentation required for health-related services (e.g., blood-glucose monitoring, nebulizer care LIC 9166, gastrostomy-tube care LIC 701A and LIC 701B) Consent for Emergency Medical Treatment forms (LIC 627)
Unusual Incident/Injury or Death Reports (LIC 624) Parents’ Rights (LIC 995) receipts, signed and dated.
Personal Rights receipts (LIC 613), signed and dated.

The Facility maintains on hand all records required by LIC 311A (Records to be Maintain at the Facility)

At the time of the inspection, the LPA observed appropriate Staffing Ratio and Capacity: Staffing ratios per number of children in care was in compliance.

Per Center Supervisor and Staff interviewed all children in care are accorded with their Personal Rights. Each child in the facility receiving services is treated with dignity and respect and have certain rights that will never be waived or abridged by anyone providing services in the facility regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
(1) To be treated with dignity in his/her personal relationship with staff and other persons.
(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

The Center Supervisor and staff are aware of Title 22 Reporting Requirements in accordance with Title 22 (101212) including to notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

LIC809 (FAS) - (06/04)

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