191202176-4-18-2023-12-CC-AALH-CQZQEA-20230418120601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191202176
Report Date: 04/18/2023
Date Signed: 04/18/2023 12:06:29 PM

Document Has Been Signed on 04/18/2023 12:06 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	CHRIST LUTHERAN CHURCH		FACILITY NUMBER:	191202176
ADMINISTRATOR:	MONICA SANTIAGO-VENEGAS		FACILITY TYPE:	850
ADDRESS:	25816 NORTH TOURNAMENT ROAD		TELEPHONE:	(661) 259-0302
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	92	CENSUS: 72	DATE:	04/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director Monica Santiago		TIME COMPLETED:	12:30 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 04/18/2023 at 9:00a.m. Licensing Program Analyst (LPA) Andrew Alemoh was greeted by above facility’s Director, Monica Santiago Venegas. LPA was at the facility to conduct an unannounced random annual inspection. LPA disclosed the purpose of the visit and was granted entry to the facility by Director, who also guided LPA on a tour of the facility. The facility's operating hours are Monday through Friday 7:00 a.m. to 6:00 p.m. Per the Director, the facility does not transport any children. The facility uses 7 classrooms for child care, which are all located behind the church. LPA observed: a 8 children to 1 staff ratio inside classroom Room 4 (preschool office is located in front of Room 4), a 9 children to 2 staff ratio inside of classroom 1B, a 10 children to 2 staff ratio inside of classrooms 2B, a 11 children to 2 staff ratio in classroom 3B, a 9 children to 1 staff ratio inside of classroom 1A, a 8 children to 1 staff ratio inside of classroom 2A, a 9 children to 1 staff ratio inside classroom 3A. All staff members were fingerprint cleared and associated to the above facility. Furniture and equipment were inspected for operable conditions and age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage for children's belongings. All classrooms have storage closets that are filled with extra toys. Children have access to water through water pitchers and disposable water cups located inside of each classroom. The facility uses the Director's office to isolate sick children. Children are provided with mats and bedding for nap time. Per the Director, the facility washes the bedding every week.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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: CHRIST LUTHERAN CHURCH	FACILITY NUMBER: 191202176
	VISIT DATE: 04/18/2023

NARRATIVE

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Age appropriate sinks and toilets were inspected. Toilets flush properly; toilets and sinks are reachable by the children. LPA inspected the restroom located to the left of classroom 1. The restroom consisted of five toilets and four sinks as well as a changing station. All toilets and sinks were found to be in operable condition, and met the Title 22 requirements. There is a storage cabinet in the restroom that store extra clothes for the day care children. Director stated staff had a separate restroom which is located inside of the church. All classrooms have sinks and or portable sinks. Cleaning supplies are stored inaccessible to children by being high enough where children are unable to reach.

First Aid supplies, smoke detector, carbon monoxide and fire extinguishers were observed and in operable condition. The fire extinguisher (2A10BC) is in operable condition. Trash cans with tight lids were observed. The facility provides afternoon snacks, and the children bring their own snacks and lunch from home. Food was inspected and it was properly labeled, stored, and within expiration date. The off limits kitchen area is adequately equipped, clean, and free from hazards. The facility has a child proof doorknob on the kitchen door preventing the children from having any access to this area. The kitchen has a sink, stove, refrigerator, and dishwasher. Menu is posted, dated, and accessible for parent’s review. Facility also stores medications in a box located inside of the office. LPA observed an allergy list posted in the Director's office and in each classroom.

The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, conditions and age appropriateness. Climbing structures, slides, and play equipment were found to be securely anchored with resilient cushioning material underneath and around the perimeter. Children have access to water through water pitchers and disposable cups during outdoor activities. The playground is fenced all around, and no bodies of water observed in the outdoor play area. The playground area has a shaded rest area for the children.

Children and staff files were reviewed and found to be complete. The facility roster and fire drills were up to date, and all staff have been fingerprinted and associated to the facility. The facility director has a current CPR and Pediatric First Aid certification, which expires on 05/2023. Mandated Reporter training expires on 09/21/23. During the inspection LPA observed adequate teacher child ratio in each classroom. The parent board was reviewed and had all of the required forms posted and accessible to parents.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: CHRIST LUTHERAN CHURCH	FACILITY NUMBER: 191202176
	VISIT DATE: 04/18/2023

NARRATIVE

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The following was discussed with the director:

Smoking is prohibited on the premises of a child care center; Earthquake safety and necessity of drills are to be conducted every 6 months and logged; Required forms for children’s files, facility files, staff files, and posting requirements; Fingerprint clearances and the transfer process.

The director was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

The above facility was found to be in substantial compliance, and no deficiencies were cited during today’s inspection.

An exit Interview was conducted, a copy of this report, and notice of site visit was provided to Director, Monica Santiago Venegas.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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