197412640-8-31-2023-12-CC-AALH-CV8Q69-20230831115311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412640
Report Date: 08/31/2023
Date Signed: 08/31/2023 11:53:21 AM

Document Has Been Signed on 08/31/2023 11:53 AM - 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:	NORTHLAKE HILL COMMUNITY PRESCHOOL		FACILITY NUMBER:	197412640
ADMINISTRATOR:	JACKLINE VASQUEZ		FACILITY TYPE:	850
ADDRESS:	32545 RIDGE ROUTE ROAD		TELEPHONE:	(661) 257-4560
CITY:	CASTAIC	STATE: CA	ZIP CODE:	91384
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 45	CENSUS: 18	DATE:	08/31/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director Melanie Long		TIME COMPLETED:	12:30 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	On 08/31/2023, Licensing Program Analyst (LPA) Alemoh met with the facility Director, Melanie Long for the One Year Required inspection for the preschool license in accordance with the facility sketch. A tour of the facility was conducted. Upon arrival LPA observed 18 preschool children and 4 teachers on the premises, along with the Director. The hours of operation are 8:15AM-11:45PM Monday - Friday Incidental Medical Services (IMS) were discussed. There are two classrooms that facilities utilizes: Class RM 01: LPA observed 10 children and 1 teacher and aide. Their are three desks and two trash cans with tightly fitted trash bags. Six cabinets were observed to contain extra learning materials, arts & crafts, toys and play equipment. A fire extinguisher(3A40BC x2) was observed to be in compliance with regulations. Sign and out sheets were observed and reviewed. One sink in the classroom. Per teacher the classroom sink is for washing hands and paint brushes. Underneath the classroom sink were locked cabinets. Class RM 02: LPA observed 8 children and 1 teacher and a aide. A classroom sink for children to wash their hands and painting materials. Three restrooms with 3 toilets, and 3 sinks. A staff restroom was observed in the classroom as well. A trash can with tightly fitted trash bag. Two cabinets were observed in the classroom to have extra learning materials such as arts & crafts, coloring/reading books, and play equipment. Three desk for children to sit and work. Two 3A40BC fire extinguishers. Allergies list was posted in both classrooms.

Mariela Ramon
Andrew Alemoh
	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: NORTHLAKE HILL COMMUNITY PRESCHOOL	FACILITY NUMBER: 197412640
	VISIT DATE: 08/31/2023

NARRATIVE

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Indoor/Children’s Area:
Child care center is clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds inaccessible and locked in the office, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with name) for his/her clothing, personal belongings and or bedding (stored separately). There is a working telephone.

Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors (Drinking water is available inside the center in the form of filtered water to fill up each child's water bottle). LPA observed a sufficient quantity of cots available for preschool children. All materials and surfaces are toxic free are inaccessible, no fireplace. There is a working Carbon monoxide detector, smoke detector.

Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file.

Facility Records: Roster, fire/disaster drill log last completed on 08/22/23, CPR/First Aid, and mandated report training were reviewed.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty.The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394L), emergency disaster plan, earthquake preparedness checklist.

Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: NORTHLAKE HILL COMMUNITY PRESCHOOL	FACILITY NUMBER: 197412640
	VISIT DATE: 08/31/2023

NARRATIVE

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Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. CPR/First Aid expires on 04/25. Mandated Reporter Training expires on 08/25/2025

Electrical outlets are inaccessible, recalled and or prohibited toys or sleep/play equipment were observed on the premises. There are no window cords accessible to children. Child nap on cots.

Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Fire/earthquake drills current. Roster current.

Restrooms: LPA inspected and observed 3 toilets and 3 sinks. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate. There is an isolation area for children who become ill while in care located in the classroom, facility maintains a comfortable temperature at all times, first aid supplies (thermometer, bandages, scissors), sign in/out sheets (Electronically and manually) available and completed daily. No Smoking prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Napping: Per teachers/aid statements the day care children do not nap at the facility however their are cots available if children wish to nap.

Outdoor: The facility has one playground area for the preschool children. Outside play area is completely fenced in with an iron fence Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. There is a grass field and concrete areas for active play. Play structure was observed on the premises to be sturdy and age appropriate. The area was observed to be free of debris, free from hazard, holes, broken items, debris, cushioning material underneath. There are areas for shade and rest. Preschool children have their own personal water bottles as well as disposable cups. Two trash cans with tightly fitted trash bags. LPA observed a storage shed that is off-limits to the preschool children and remained locked.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: NORTHLAKE HILL COMMUNITY PRESCHOOL	FACILITY NUMBER: 197412640
	VISIT DATE: 08/31/2023

NARRATIVE

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Teacher child ratios were observed and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.

Health Related Services: Medications inaccessible to children; all prescription and non-prescription medications have child’s name and are dated; written consent and instruction from child’s representative, a plan to document and report to child’s representative when medication is administered to a child; IMS plan on file (if applicable).

Children are inspected for illnesses (wellness policy) as they arrive. Per staff statements there is no children on medication at the facility. A review of medication policy indicated that prescription medication is administered only with parent's written permission (licensing medication form- LIC9221 - also used). LPA advised the Director must administer medication, and document the dosage, date and time onto a log. Medication can be brought and taken home by the parent daily. Medication will be properly labeled and stored in its original container.

This facility provides Incidental Medical Services – IMS. Currently no 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/childquanda.htm

Food Service: The facility currently does not have a food program. Meals such as AM snack is provided. LPA inspected the kitchen where food is prepared and observed the food menu. The kitchen is off limits to preschool children.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: NORTHLAKE HILL COMMUNITY PRESCHOOL	FACILITY NUMBER: 197412640
	VISIT DATE: 08/31/2023

NARRATIVE

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Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Director shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
No deficiency.

Exit interview conducted and report was reviewed with Director Melanie Long . This report was read and provided to Director Melanie Long , along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

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