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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407737
Report Date: 10/12/2021
Date Signed: 10/13/2021 08:26:14 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:CASTAIC COMMUNITY PRESCHOOLFACILITY NUMBER:
197407737
ADMINISTRATOR:JACKELINE VASQUEZFACILITY TYPE:
850
ADDRESS:28900 HILLCRESTTELEPHONE:
(661) 257-4550
CITY:CASTAICSTATE: CAZIP CODE:
91384
CAPACITY:24CENSUS: 5DATE:
10/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Jackeline Vasquez TIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Carol Heath met with the Director Jackeline Vasquez for the purpose of conducting an unannounced Annual/Random inspection. The operating hours of the center are Monday through Friday form 8:00 am to 3:30 Pm. This is a preschool center. The facility utilizes one classroom for the care of children.

Furniture and equipment were inspected for age appropriateness and good repair. Center provides potty training. There were no changing tables present, Director mentioned diaper changing is done standing. The center utilizes two restrooms for children under care. Age appropriate sinks and toilets were inspected for availability and good repair. All toilets, hand washing facilities were in safe and sanitary operating condition. Toilet paper and paper towels were observed inside the restrooms.

Bedding and linens were individually stored so that each child's bedding is identifiable, and no child's used bedding comes into contact with other bedding.
Telephone service, heating, lighting and ventilation were evaluated. The LPA observed individual cubbies with children’s names. The floors and area rugs are kept clean and safe. Disinfectants, cleaning solutions, and other items that are dangerous to children are inaccessible to children.

There is a clean refrigerator, freezer (1), stove and microwave oven. The facility provides a snack. A menu is posted inside the classroom. Trash bins with tight fitting lids for solid waste were observed. Uncontaminated drinking water is readily available inside the classroom from a water fountain. Allergy lists and food menus are posted in classrooms. LPA observed an appropriate amount of food and snacks. Cleaning solutions are stored separately away from the food (locked cabinet).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: CASTAIC COMMUNITY PRESCHOOL
FACILITY NUMBER: 197407737
VISIT DATE: 10/12/2021
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The outside was inspected. There were no bodies of water observed in the playground area. The outdoor playground was inspected and was observed to be free of hazards, loose and sharp parts. There are two shaded areas for play. A water fountain is available for children to drink water from. The playground was observed to be properly gated all around. Equipment was inspected for safety, cushioning material, good repair and age appropriateness.

Children files and Staff files were complete with all required licensing forms. The facility roster was up to date. The sign in and out sheet was observed inside the classroom. All staff have been fingerprinted and associated to the designated license number. The center has 2 staff are currently certified in pediatric CPR and first aid which expires on 2022. The facility had all the required licensing forms posted. The parent board was reviewed and has all of the required forms posted. LPA observed the Fire/earthquake drills current.

LPA observed a fully stocked first aid kit; fully charged fire extinguishers (7/19/2021); carbon monoxide detectors throughout the center.

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 ADA, available at: http://www.ada.gov/childqanda.htm
The following general information was discussed during this inspection:

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. Center does not provide IMS at this time.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: CASTAIC COMMUNITY PRESCHOOL
FACILITY NUMBER: 197407737
VISIT DATE: 10/12/2021
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Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, child care providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.



*All Licensing reports are available for review on-line and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.

Safe Sleep Information: California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

Fingerprint clearances and transfers: Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state licensed facility to another using form LIC 9184
A copy of this report must be made available to the public for 3 years.

There were no citations issued during today's inspection. An exit interview was conducted, copies of the inspection report & Notice of Site Visit were provided to Jackeline Vasquez
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3