191201899-3-5-2020-12-CC-BTSA-BMF2FL-20200305162144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191201899
Report Date: 03/05/2020
Date Signed: 03/05/2020 04:22:01 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:	LANCASTER UNITED METHODIST CHURCH PRE SCHOOL		FACILITY NUMBER:	191201899
ADMINISTRATOR:	DAMON, TAMMY		FACILITY TYPE:	850
ADDRESS:	918 WEST AVENUE J		TELEPHONE:	(661) 942-0812
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	58	CENSUS: 45	DATE:	03/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:34 PM
MET WITH:	Tammy Damon (Director)		TIME COMPLETED:	04:36 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	Licensing Program Analysts (LPAs) Tsutaoka and Thompson-Miller met with Director Tammy Damon today for the purpose of conducting an unannounced Annual/Random inspection. This Pre-school program is held on the grounds of Lancaster United Methodist Church located in classrooms 4, 5, 6, and 10. Pre-School utilizes 4 classrooms and operates Monday through Friday, from 5:30 AM until 6:00 PM. Rooms 4, 6, and 10 had two teachers during nap time. LPAs observed rooms 4 and 5 were combined during nap time. Present today in classroom 4 is 15 children, in classroom 6 is 12 children, and in classroom 10 is 18 children. Teacher and child ratios were observed. The preschool has its own enclosed play yard. Children's records are reviewed and are in compliance. Staff files contain required licensing documentation. LPAs verified that required forms are posted from the Department. Fire drill and earthquake drill is posted and is completed monthly. Last drill was conducted February 21, 2020. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings. LPA observed age appropriate toys and materials. Drinking water is available inside the classrooms in the form of a water cooler and disposable cups. Water is also provided outside to children using a cooler and paper cups.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL	FACILITY NUMBER: 191201899
	VISIT DATE: 03/05/2020

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
26
27
28
29
30
31
32

LPAs inspected and observed two children's bathrooms which are located right outside classroom number 10 at the end of the hall. The girls’ bathroom had two toilets and one sink. The boys’ bathroom had one toilet, one urinal, one changing table, and one sink. Bathrooms were found to be clean and sanitary, bathrooms contained hand soap, toilet paper and paper towels which were readily available. Toilets and sinks are functioning properly and age appropriate.
A review of the sign in/out sheet was conducted to verify the current census of children. LPA notes the carpet and tile floors to be in good condition. Parent board with community and licensing forms available to view.

Whenever a Type A deficiency is cited:

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of the children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, a copy of this report must remain posted for 30 days along with the Notice of Site Visit.

Meals are prepared for children. Center serves morning snack, lunch, and afternoon snack. Menus are posted for parents to view, food preparation area is adequately equipped, clean and free from hazards. Cleaning supplies are out of reach of children and stored separately and away from food. Director states the classrooms and kitchen are cleaned every evening by staff. Trash cans have lids. There is a First Aid cabinet which contains First Aid supplies and medication. Medication is kept out of reach of children in a top cabinet. Staff advised that children should be screened every morning for illness and any unusual marks.

A review of medication policy indicated that over the counter or prescription medication is administered to children at the behest of the parent by director or lead teacher.
There is a separate area for isolation in the director’s office and the parents are immediately called to come pick up the child when child is ill.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: LANCASTER UNITED METHODIST CHURCH PRE SCHOOL	FACILITY NUMBER: 191201899
	VISIT DATE: 03/05/2020

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
26
27
28
29
30
31
32

Staff are certified in pediatric First Aid and CPR (Expires 10/05/2020).
Inspection of the outdoor play area was conducted. LPA noted adequate resilient cushioning material underneath and around the perimeter. Drinking water is readily available on the play yard. There is adequate shade for the children in care. Fencing encompasses entire play yard. Playground is free from miscellaneous debris such as tree branches, trash, leaves, etc. Outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. Large play equipment and structures are securely anchored. There is an area for shade and rest.

Play area was inspected for hazards and inaccessibility to bodies of water.

There is an operating telephone, two fully charged fire extinguishers, carbon monoxide and smoke detector along with fire alarm.

Incidental Medical Services (IMS) policy was discussed. 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

There were no violations noted as a result of this unannounced Annual/Random inspection. Exit interview conducted and a copy of this report was read and provided to Director Tammy Damon.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3