197407546-8-27-2019-12-CC-TLAN-BFFQG9-20190827120911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197407546
Report Date: 08/27/2019
Date Signed: 08/27/2019 12:09:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	NOAH'S ARK PRESCHOOL-QUARTZ HILL FOURSQUARE CHURCH		FACILITY NUMBER:	197407546
ADMINISTRATOR:	THOMPSON, MICHELLE		FACILITY TYPE:	850
ADDRESS:	6015 WEST AVEUNE J-8		TELEPHONE:	(661) 943-4440
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	60	CENSUS: 0	DATE:	08/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:54 AM
MET WITH:	Recel Casuncad		TIME COMPLETED:	12:21 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	Licensing Program Analyst's (LPAs) Lawson and San met with the facility Director, Recel Casuncad, for the purpose of conducting a Random Annual Inspection for the preschool. A tour of the facility was conducted. Upon arrival LPA observed five classrooms. The center operates Monday through Friday 8:30 AM - 12:00 PM. Furniture and equipment were inspected for age appropriateness and good repair. All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings. LPAs observed age appropriate toys and materials. Drinking water is available inside the classrooms in the form of water dispenser/ pitcher and disposable cups. Due to the hours of operation, children do not nap. There is a fire extinguisher, smoke detector and a carbon monoxide detector on the premises. There is a First Aid Kit. Staff are certified in Pediatric CPR and First Aid expires 01/2020. LPAs inspected and observed three clean bathrooms. Toilets and sinks are functioning properly and are age appropriate. LPAs observed soap, toilet paper and paper towels readily available. Wellness Policy: Children are inspected for illnesses as they arrive. There is a separate area for isolation of ill children in the office area (mats available). Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Snack Menu is posted. Fire/earthquake drills current. Roster current.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: NOAH'S ARK PRESCHOOL-QUARTZ HILL FOURSQUARE CHURCH	FACILITY NUMBER: 197407546
	VISIT DATE: 08/27/2019

NARRATIVE

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Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. The play area has grass and mulch for cushioning. The area was observed to be free of debris. There is an area for shade and rest. Water pitcher and disposable cups are brought outside during play. Play area is inaccessible to bodies of water. Jungle Gym is anchored.

There is a clean fully equipped kitchen (off limits) with refrigerator, freezer, stove and microwave oven. The facility provides light snack. Allergy lists are kept with the teachers in the classroom. LPAs observed an appropriate amount of snacks. The chemicals are kept separate from the food.

Incidental Medical Services (IMS) policy was discussed, facility is not currently providing IMS. 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

Additional forms and a copy of Title 22 Regulations may be obtained at the department's website www.ccld.ca.gov.

--Director was informed of responsibility to report suspected Child Abuse, 1-800-827-8724

--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

No deficiencies cited according to Title 22 Regulations. Consultation provided during the inspection.

Exit Interview conducted and a copy of report read and provided to Director, Recel Casuncad.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

LIC809 (FAS) - (06/04)

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