191805520-5-16-2023-12-CC-AALH-CRVT2J-20230516142048

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191805520
Report Date: 05/16/2023
Date Signed: 05/16/2023 02:21:06 PM

Document Has Been Signed on 05/16/2023 02:21 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:	SUNLAND ELEMENTARY SCHOOL(STATE PRESCHOOL)		FACILITY NUMBER:	191805520
ADMINISTRATOR:	ORNELAS, LISA D. DACHS		FACILITY TYPE:	850
ADDRESS:	8350 HILLROSE STREET		TELEPHONE:	(818) 951-3197
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	23	CENSUS: 6	DATE:	05/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Lead Teacher Belen Ascencio		TIME COMPLETED:	02:30 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 05/16/2023 Licensing Program Analyst (LPA) Andrew Alemoh met with the facility Lead Teacher , Belen Ascencio, for the purpose of conducting a Random Annual Inspection for the State Preschool. This is a Title 5 LAUSD Preschool Program located in Room 4 on the premises of Sunland Elementary School. A tour of the facility was conducted. Upon arrival LPA observed 6 preschool children and 3 staff. The program runs two daily sessions Monday-Friday. The first session is from 7:50AM - 10:50AM and the second is from 11:30 AM to 2:30 PM. Incidental Medical Services (IMS) policy was discussed. Furniture and equipment were inspected for age appropriateness and good repair. The classroom is clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children to place there belongings by the classroom entrance. LPA observed age appropriate toys and materials. There tables in the classroom for children to eat and utilize for play/learning activities. Children bring there own water bottles to the facility, as well as drinking fountains outside the classrooms. Due to the hours of operation, children do not nap. There is a First Aid Kit, Fire Extinguisher(2A10BC), Smoke Detector and a Carbon Monoxide Detector on the premises.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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: SUNLAND ELEMENTARY SCHOOL(STATE PRESCHOOL)	FACILITY NUMBER: 191805520
	VISIT DATE: 05/16/2023

NARRATIVE

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LPA inspected and observed one clean bathroom with two toilets and one sink. Toilets and sinks are functioning properly and are age appropriate. There is a divider between the toilets for privacy. LPA observed soap, toilet paper and paper towels readily available. Additional sink is located in the classroom.

Children are inspected for illnesses (wellness policy) as they arrive. No children in care have incidental medical needs at this time. If a child in care did need Incidental Medical Services, they would be referred the the nurses office. Children are sent to the front office to wait for pick up when they are ill.

Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. The play area is mostly concrete, there is a foam padding under the climbing apparatus. There are bikes, bouncing balls and an empty sand box. The area was observed to be free of debris. There is an area for shade and rest. There are four water fountains located in the play area. Play area was inspected and found to be free of hazards and inaccessibility to bodies of water. Large jungle gym is anchored. LPA observed three locked storage sheds in the play yard area. Per teacher the storage sheds contain extra toys and play equipment for the children. The fire hydrate and water pipe is blocked off by an iron fence which is locked at all times. On the left side of the play yard there is locked gate for pickup/drop off. LPA observed three trash cans with tightly fitted trash bags.

Meals and snacks are provided by LAUSD. Menus are posted.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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: SUNLAND ELEMENTARY SCHOOL(STATE PRESCHOOL)	FACILITY NUMBER: 191805520
	VISIT DATE: 05/16/2023

NARRATIVE

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Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Fire/earthquake drills current. Roster current.

Teacher child ratios were observed and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. During inspection LPA observed Lead teacher conducting story time and the teacher aides preparing an activity.

Children's records and staff records are kept in the LAUSD district office. Records were reviewed and current. Staff are certified in Pediatric CPR and First Aid expire Jan 2024 .

Additional forms and a copy of Regulations may be obtained at the department's website www.ccld.ca.gov.

--Lead Teacher was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Child Care Centers (Disaster Planning information):https://cccld.childcarevideos.org/child-care-center-operators/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: SUNLAND ELEMENTARY SCHOOL(STATE PRESCHOOL)	FACILITY NUMBER: 191805520
	VISIT DATE: 05/16/2023

NARRATIVE

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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

No deficiencies cited. Consultation provided during the inspection.

Exit Interview conducted and a copy of report read and provided to Lead Teacher Belen Ascencion.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

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