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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402355
Report Date: 02/24/2020
Date Signed: 02/24/2020 03:33:26 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:FERNANGELES ELEMENTARY SCHOOL ROOM 9FACILITY NUMBER:
197402355
ADMINISTRATOR:JAYE, KAREN A.FACILITY TYPE:
850
ADDRESS:12001 ART STREETTELEPHONE:
(818) 767-0380
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:22CENSUS: 22DATE:
02/24/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:39 AM
MET WITH:Maria MartinezTIME COMPLETED:
03:36 PM
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Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced annual random inspection. LPA met with Lead Teacher, Maria Martinez. LPA inspected the facility inside and outside. Upon arrival during morning session LPA observed 22 children in care and 5 staff, during the afternoon session 14 children and 3 staff were present.

This a State Preschool Program Title V, on Los Angeles Unified premises which takes place in room 9 at Fernangeles Elementary School. This facility has two sessions; morning(8:05 AM to 11:05 AM and afternoon(11:45 AM to 2:45PM). During inspection Lead Teacher stated this school year facility is participating in a program called Preschool for all Learners(PAL) in collaboration with California State preschool, this is a mainstream program with the State Preschool. The Facility shall submit a waiver for approval consideration, have staff fingerprint cleared and associated to designated Center License, meet all Child Development units requirement, provide Mandated Reporter Training certification, and provide immunization requirements for staff(advisory given).
The Facility provides breakfast for the morning class and lunch for the afternoon class. Facility participates in the Nutrition Food Program. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. There is hot and cold running water in the kitchen/food preparation area. Food preparation area is adequately equipped, clean, and free from hazards. Cleaning supplies are stored separately and away from food. Menu is posted for parent review inside the classroom and an allergy list is posted in the kitchen area where food is prepared.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
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: FERNANGELES ELEMENTARY SCHOOL ROOM 9
FACILITY NUMBER: 197402355
VISIT DATE: 02/24/2020
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Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual cubbies with children’s names. An advisory was given for staff’s personal belongings shall be kept inaccessible to children. The facility uses the nurses office to isolate sick children, also in the classroom there is a designated area to isolate sick children. Children do not nap since children are only in the facility for half a day (3 hours). The floors and carpet areas are kept clean and safe. All disinfectants, cleaning solutions, and other items that may pose a danger to children are out of reach and stored in cabinets inaccessible to children.

Age appropriate sinks and toilets were inspected for availability and good repair for the exception of one toilet (handicap toilet) in the girls restroom according to facility this toilet is being repaired and replacement parts/materials have been ordered. Toilet paper, hand air dryers were observed inside the restroom. First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers(serviced on 10/21/2019) were observed and in operable condition meeting the Fire Marshal standards. Facility conducts emergency drills every six months last drill conducted today at 10:30 AM.

Trash cans with tight lids were observed outside the classroom. The restrooms are located outside of the classroom (restrooms are separated by gender) which are on the elementary school premises(waiver on file). According to Lead Teacher staff always provide supervision and walk with children during restroom usage.

Uncontaminated filtered drinking water is readily available in the classrooms and during outdoor play facility provides children with water bottles. Water is readily accessible to children at all times.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
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: FERNANGELES ELEMENTARY SCHOOL ROOM 9
FACILITY NUMBER: 197402355
VISIT DATE: 02/24/2020
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Children files were complete with all required licensing forms. Staff files are maintained in an off site Human Resource office (Staff files will be inspected at a later time). The sign in and out sheets were observed inside the classroom. The center staff has current pediatric CPR and First Aid which expires on 8/20/2021. The facility had all the required licensing forms posted.

There were no bodies of water observed on the premises. The outdoor playground was inspected and was observed to be in good repair, free from loose and sharp parts. Equipment was inspected for safety, age appropriateness and are in good repair. The playground was observed to be properly fenced all around (staggered schedule waiver on file). The following was discussed: The following Incidental Medical Services (IMS) were discussed.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Staff provided mandated reporter training certificate dated 9/7/2018.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: FERNANGELES ELEMENTARY SCHOOL ROOM 9
FACILITY NUMBER: 197402355
VISIT DATE: 02/24/2020
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For additional information and forms visit our website at: www.cdss.ca.gov

For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

Facility was advised to visit CCL web site for lead water testing regulations.

The facility was in compliance per Title V Regulation. Facility was not cited and no deficiencies were issued, according to California Code of Regulations Title V.



Exit interview conducted, a copy of this report, appeal rights and notice of site visit was discussed and provided to Lead Teacher Maria Martinez.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4