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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418481
Report Date: 07/20/2020
Date Signed: 07/20/2020 08:28:20 PM

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:PACOIMA CHARTER SCHOOLFACILITY NUMBER:
197418481
ADMINISTRATOR:FAJARDO, SYLVIAFACILITY TYPE:
850
ADDRESS:11016 NORRIS AVETELEPHONE:
(818) 899-0201
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY:70CENSUS: 30DATE:
07/20/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Sylvia FajardoTIME COMPLETED:
12:56 PM
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On 7/20/20202 Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced Case Management site inspection for an increase of capacity request. Facility requested to add one more classroom(#4) requesting a capacity increase for a total of 100 children. The LPA met with Director Sylvia Fajardo and Early Childhood Coordinator Maria Arizon. who guided the LPA on a tour during today's inspection.
The operating hours of the center are Monday through Friday from 8:00 am to 4:00 p.m. This is a preschool center offering a full day session. The facility utilizes classrooms 1, 2, 3 and 4 for day care.

The inside and outside of the center were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. The LPA observed individual cubbies with children’s names. The center provides nap time, cots are provided. 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.

The center utilizes 9 toilets and 2 urinal stalls for day care children. Four age appropriate sinks are available for children in the classroom and four sinks are available outside of the classrooms. Toilets were observed outside the classrooms all toilets, hand washing facilities were in safe and sanitary operating condition. Toilet paper and paper towels are available for children.

First Aid supplies were observed. Smoke detectors, carbon monoxide detectors(dual) and fire extinguishers were observed and found to be in operable condition last serviced July 13, 2020. Fire and disaster drills are conducted at least once every six months and logged last drill was conducted 3/18/2020 at 3:54PM.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2020
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 2
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: PACOIMA CHARTER SCHOOL
FACILITY NUMBER: 197418481
VISIT DATE: 07/20/2020
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Continuation:

The following measurements were taken:

Indoor activity area measurements:
Classroom 1: 23 x 35 = 805 sq. feet Divided by 35 = 23
Classroom 2: 23 x 35 = 805 sq. feet Divided by 35 = 23
Classroom 3: 23 x 35 = 805 sq. feet Divided by 35 = 23
Classroom 4: 23 x 35 = 805 sq. feet Divided by 35 = 23
Total indoor activity space: 3,220 sq. feet divided by 35 = 92 children

Total children toilets, stalls and sinks:
8 sinks, 9 toilets and 2 stalls

Outdoor activity area measurements:
Total outdoor activity space: 5250 divided by 75 = 70 children. Facility will have a staggered schedule to alternate outdoor space. No more than two classrooms will rotate outdoor play at a given time.

Fire Clearance was granted on 7/13/2020 for 100 children but space permits 92 children 23 children per classroom. Facility will be granted for a total Capacity of 92 children.
Per California Code of Regulations Title 22, no deficiency cited during today's case management inspection on 07/20/2020.

Exit interview conducted, and a copy of this report and notice of site visit and appeal rights will be provided to Director Sylvia Fajardo.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2020
LIC809 (FAS) - (06/04)
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