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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192001286
Report Date: 11/10/2021
Date Signed: 11/10/2021 11:22:46 AM

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-MONTE VISTA ELEMENTARY STATE PRESCHOOLFACILITY NUMBER:
192001286
ADMINISTRATOR:FOUNTAIN, KELLYFACILITY TYPE:
850
ADDRESS:1235 WEST KETTERINGTELEPHONE:
(661) 723-0351
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:24CENSUS: 12DATE:
11/10/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Ruth WhiteTIME COMPLETED:
11:30 AM
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Licensing Program Analysts (LPA's) Maddox and Heath conducted and unannounced Case Management inspection today and met with Ms. Ruth White, Budget Technician. The purpose of this inspection was to measure classroom 40 because PS1 classroom was flooded. The children will use Classroom 40 until January 2022.
The measurements were as follows:
22x38 = 836
836 / 35 = 24

Bathroom is located outside the classroom. 2 doors down. There is a boys bathroom (2 toilets, 2 urinals and 2 sinks) and a girls bathroom (4 toilets and 2 sinks). The children use preschool playground located next to PS1 (Old preschool classroom). The children are escort by the teachers to the play yard.
LPAs observed fully charged Fire Extinguisher, Carbon monoxide detector, fully stocked first aid kits, forced heating and air, all unused outlets are plugged, telephone service, hand sanitizer, COVID-19 postings along with other required forms were observed on the parent board, cleaning supplies are inaccessible to children (710 cleaning and disinfectant), menu's posted, and age appropriate materials.

There are no health or safety hazards observed as a result of this inspection.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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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