197412826-3-24-2023-12-CC-AVIA-CQ8S7F-20230324133728

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412826
Report Date: 03/24/2023
Date Signed: 03/24/2023 01:38:22 PM

Document Has Been Signed on 03/24/2023 01:38 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:	STONEHURST ELEMENTARY SCHOOL STATE P.S.		FACILITY NUMBER:	197412826
ADMINISTRATOR:	IMPERIALE, JILL		FACILITY TYPE:	850
ADDRESS:	9851 STONEHURST AVENUE RM. 2		TELEPHONE:	(818) 767-8014
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY:	24	CENSUS:	DATE:	03/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:03 AM
MET WITH:	Melissa Herrera, Teacher		TIME COMPLETED:	01:45 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 March 24, 2023, Licensing Program Analyst (LPA) Annelise Villa and met with the classroom’s teacher, Melissa Herrera for the One Year Required inspection. This is an LAUSD state preschool program located on the premises of Stonehurst Elementary School. A tour of the facility was conducted. Upon arrival LPA observed 1 classroom in use with a total of 8 preschool children. There were two teachers on the premises working under the facility’s License. The hours of operation are 7:40 a.m. – 2:40 p.m. Monday - Friday. Incidental Medical Services (IMS) were discussed. Indoor/Children’s Area: Preschool is currently operating out of a temporary classroom on campus (as of 3/24/23). Licensed room was damaged due to rain storms. 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 the classroom has a surface that is safe and clean, cleaning compounds inaccessible, 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). Trash cans for solid waste have tight fitting lids and children bring drinking water is reusable cups from home. All materials and surfaces are toxic free are inaccessible and there is no fireplace. There are working carbon monoxide detectors, smoke detectors and Fire Extinguishers (2A10BC). There is a working landline telephone on the premises. Restrooms: LPA inspected and observed 2 gendered restrooms for children. Restroom #1 and #2 located across the temporary classroom. Each restroom had 8 toilets and 5 sinks. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate. Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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: STONEHURST ELEMENTARY SCHOOL STATE P.S.	FACILITY NUMBER: 197412826
	VISIT DATE: 03/24/2023

NARRATIVE

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Napping: The facility’s morning program runs from 7:00 am to 10:30 am and the afternoon program runs from 11:40 to 3:30 pm. The two programs have separate groups of children, therefore, no naps are taken at the facility.

Outdoor: Outside play area is completely fenced. Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. The area was observed to be free of debris, free from hazard, holes, broken items, debris, No bodies of water were observed. There are areas for shade and rest. LPA observed one storage shed in the playground area to be secured and locked.

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 10/20/2022, CPR/First Aid (expires 8/2024), and mandated report training (expires 9/2023) 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.

Advisory/Other: First aid supplies (thermometer, bandages, scissors) readily available in the classroom office. There is also a school nurse on campus available to the children if necessary. There is an isolation area for children who become ill while in care located in the school’s office, facility maintains a comfortable temperature at all times, sign in/out sheets available and completed daily. Smoking is prohibited on the premises, and daily inspection for illness is conducted. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: STONEHURST ELEMENTARY SCHOOL STATE P.S.	FACILITY NUMBER: 197412826
	VISIT DATE: 03/24/2023

NARRATIVE

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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

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

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: No medications are stored on the property, however, teacher is aware all prescription and non-prescription medications must have child’s name and are dated, written consent and instruction from child’s representative, and a plan to document and report to child’s representative when medication is administered to a child; IMS plan was discussed and Director understands when IMS is necessary.

Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is administered only with parent's written permission (licensing medication form- LIC9221 - also used). Per Director, she does not have children enrolled who require medication. 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. There is a separate area for isolation and care of ill children in the office.

Currently no Incidental Medical Services are provided to children in care. LPA reviewed 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

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: STONEHURST ELEMENTARY SCHOOL STATE P.S.	FACILITY NUMBER: 197412826
	VISIT DATE: 03/24/2023

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 the day care center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

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 was cited today.

Exit interview conducted and report was reviewed with the teacher. This report was read and provided to along with her appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4