197417974-7-7-2023-12-CC-AALH-CTHU76-20230707151925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417974
Report Date: 07/07/2023
Date Signed: 07/07/2023 03:19:33 PM

Document Has Been Signed on 07/07/2023 03:19 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:	GUARDIAN ANGEL ACADEMY		FACILITY NUMBER:	197417974
ADMINISTRATOR:	ALICIA TORRES		FACILITY TYPE:	830
ADDRESS:	13413 BRADLEY AVENUE		TELEPHONE:	(818) 362-2526
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	13	CENSUS: 4	DATE:	07/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Licensee Diane Ferguson		TIME COMPLETED:	04:00 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 07/07/2023 Licensing Program Analyst (LPA) Andrew Alemoh conducted an unannounced annual random site inspection. This is a dual licensed facility with a prek/preschool component (197417975) LPA met with the site licensee, Diane Ferguson. LPA inspected the inside and outside of the facility. The facility hours are from 6AM.-6PM, Monday-Friday. LPA observed 4 infants and 1 teacher and licensee caring for them. (2 infants were seen being picked up by the parents during today's inspection). Two classrooms are being used for day care; The Infant Rm and the Toddler Rm . Infant Room: 7 cribs were observed and to be in the safe sleep regulations and utilized for napping. Age appropriate toys and play equipment were observed. There is a cabinet in the classroom that is a storage unit for extra toys and play equipment. Toddler Rm: (During today inspection there were no toddlers presents). Age appropriate toys and play equipment were observed in the classroom. There is a door that gives access to the outside that was observed to be locked. 1 sink with hand soap and paper towels for children to wash there hands was observed in the classroom. Changing Rm/Bathroom: 3 toilets and 1 sink were observed. The sink had hand soap as well as paper towels for children to wash and dry hands. The changing room/bathroom was observed to be clean and orderly. A changing table was observed with extra diapers and whips readily available.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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: GUARDIAN ANGEL ACADEMY	FACILITY NUMBER: 197417974
	VISIT DATE: 07/07/2023

NARRATIVE

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Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. An isolation area was inspected. Children do nap during school hours and appropriate cribs were observed. The restroom is located in the hallway next door to the infant classroom. First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers were observed. Trash cans with tight lids were observed.

Kitchen: (Off-limits, and remained locked and inaccessible to day care children.) LPA observed one of the helpers provided food for the children. Dry snacks were seen readily available along with juice boxes, paper plates, disposable cups and napkins. Knives stored in the top kitchen cabinet high enough making it inaccessible to children. Cleaning supplies also stored in the top cabinet making it inaccessible to children. All bottom cabinets have a safety latches.

Fire and disaster drills are conducted monthly. Fire extingusher (2A10BC) was located in the kitchen to be in operation.

Per licensee there are no medications premises in the day care.

Children's files were reviewed and complete. Staff files were reviewed and not completed .Staff#2, and 3 was missing proof of immunization's. See 809D for deficiency. Mandated reporters has expired.

The facility does have a pool that is gated but the children do not have access to it all.

The outdoor playground was inspected and was observed to be free of hazards, loose and sharp parts. LPA did observed large trees that provide shade. A water jug is taken outside for children to drink water. The children play yard is the side of the home or the very back. The play yards is properly gated all around.

The following forms were observed to be posted. The facility license, Parent's Rights Poster (PUB 393), Personal Rights (LIC 613A), Emergency Disaster Plan (LIC 610), Child Car Seat Law (PUB 269).

The facility was not in compliance per Title 22 regulations, a Type B deficiencies will be cited today. An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided and appeal rights were discussed.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 03:19 PM - It Cannot Be Edited

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: GUARDIAN ANGEL ACADEMY	FACILITY NUMBER: 197417974
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(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. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the facility did not comply with the section cited above in 2 staff members did not have immunizations records on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/28/2023
	Plan of Correction
1 2 3 4	Per licensee she intends to send LPA Alemoh her two staff immunizations records no later than POC date .

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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