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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197404126
Report Date: 10/20/2022
Date Signed: 10/20/2022 04:50:29 PM

Document Has Been Signed on 10/20/2022 04:50 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:SAN FERNANDO GARDENS CHILD CARE CENTERFACILITY NUMBER:
197404126
ADMINISTRATOR:AURA OSOYFACILITY TYPE:
850
ADDRESS:10896 LEHIGH AVE.TELEPHONE:
(818) 834-7874
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 8DATE:
10/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Aura OsoyTIME COMPLETED:
04:55 PM
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On 10/20/2022 Licensing Program Analyst Isabel Ortega met with facility Site Supervisor and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. At time of entry LPA observed 8 children in care and 4 staff present in the classroom.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage with children’s name labeled for children's belongings. The classroom consists of filtered water containers with individual one time use disposable cups for children. An isolation area was inspected, which takes place in supervisors private office. Children have the option for rest time if needed mats are provided. Blankets are brought from home and are send home for washing every two week. Age appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; toilet and sinks are reachable by the children. Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms were found to be clean and sanitary.

Facility operated Monday through Friday from 6:30 a.m. to 5:30 p.m.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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: SAN FERNANDO GARDENS CHILD CARE CENTER
FACILITY NUMBER: 197404126
VISIT DATE: 10/20/2022
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First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers were observed and in operable condition. Trash cans with tight lids were observed. The center participates in a Food Nutrition Program and provides breakfast, lunch and afternoon snack for children enrolled. 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 food preparation area, it is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 10/20/2022 at 9:45 a.m. (participated in the Shake out). The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal codes and standards (last serviced 9/29/2022). Food allergies are noted and are posted in the food preparation area. Menu is posted visible for parents.

The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Climbing structures other play equipment were found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. Children are provided with filtered water with disposable one time use cups during outdoor play. There is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed in the outdoor play area. There are two sheds on the play area utilized for storage(maintained locked).

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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: SAN FERNANDO GARDENS CHILD CARE CENTER
FACILITY NUMBER: 197404126
VISIT DATE: 10/20/2022
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During the inspection LPA observed adequate teacher child ratio. Care and supervision were evaluated and determine basic needs of children are appropriate and are being met. A review of the sign in/out sheet was conducted to verify the current census of children. The parent board was reviewed and has all the required forms posted accessible to parents.

Site Supervisor and teachers are currently certified in Pediatric CPR/First Aid which expires on 9/03/2024.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number. All staff are required to take 3-hour Mandated Reporter training every 2 years. www.mandatedreporterca.com.
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
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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: SAN FERNANDO GARDENS CHILD CARE CENTER
FACILITY NUMBER: 197404126
VISIT DATE: 10/20/2022
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 Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

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. Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000.



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/

A copy of this report must be made available to the public for 3 years.

Per Title 22 Regulations facility is in compliance, no deficiency will be issued today. An exit Interview was conducted with Site Supervisor. A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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