197418892-10-16-2019-12-CC-JNEL-BGZUNJ-20191016154403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418892
Report Date: 10/16/2019
Date Signed: 10/16/2019 03:44:12 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	SUNSHINE-STEVENSON RANCH		FACILITY NUMBER:	197418892
ADMINISTRATOR:	SAM OTTMAN		FACILITY TYPE:	840
ADDRESS:	25820 N. CARROLL LANE		TELEPHONE:	(661) 290-2620
CITY:	STEVENSON RANCH	STATE: CA	ZIP CODE:	91381
CAPACITY:	165	CENSUS: 16	DATE:	10/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Sam Ottman		TIME COMPLETED:	03:55 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	Licensing Program Analyst (LPA) Neal met with Director, Sam Ottman today for the purpose of conducting an unannounced Annual/Random inspection. LPA toured and inspected all areas according to the facility sketch. This School-Age program is located on the grounds of Stevenson Ranch Elementary school and occupies 1 large modular that consists of 4 separate classrooms. Center separates children by age group (T-K/Kindergaten, 1st graders, 2nd - 3rd & 4th - 6th graders). Present today were 16 children and 4 staff persons. This is a full-day program which operates from 6:30 am to 6:30 pm (Morning session, 6:30 to 8:15 before elementary school begins and in the afternoons, 1:45 pm to 6:30 pm). LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean, safe, and free of any health and safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the wall. Drinking water is available inside the classrooms in the form of water jugs (cleaned regularly) and disposable cups. The children's bathroom is located within the modular. There are 2 bathrooms, each with 1 toilet and 1 sink, inside the modular. Children utilize 1 of the indoor bathrooms, the other is designated for staff. Children also have available the bathrooms that are part of the Elementary School (with staff escort).

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SUNSHINE-STEVENSON RANCH	FACILITY NUMBER: 197418892
	VISIT DATE: 10/16/2019

NARRATIVE

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LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate.
All flooring was observed to be clean. There are trash cans for solid waste with tight-fitting covers in good repair.

There are 3 play areas on the Elementary School grounds utilized by the center which are a large open grass area, the black top area with basketball courts, and an area with large play structures and swings, securely anchored and wood chips underneath. Yard is completely fenced. The area was observed to be free of debris. There is an area for shade and rest. Outside drinking water is available in the form of drinking fountains and/or water jug and disposable cups. There are no bodies of water.

Food preparation area/kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage, menus observed posted. LPA observed food storage area (in director's office) to be separate from toxins and cleaning compounds. Cleaning compounds are stored in a locked cabinet in one of the bathrooms, inaccessible to children. Center provides afternoon snacks.

Staff present have current pediatric CPR and First Aid training. Sign in/out is done electronically (via Kangaroo Time). There is a fully stocked emergency supply cabinet (director's office, fully charged fire extinguishers and carbon monoxide detector in place. Fire Drill/Earthquake log was observed current (logged electronically). All required documents are posted per Title 22 Regulations. A sample of Children's records and staff files were reviewed. Mandated Reporter Training was completed and is current. Staff was reminded Mandated Reporter training must be completed every two years by staff and volunteers.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SUNSHINE-STEVENSON RANCH	FACILITY NUMBER: 197418892
	VISIT DATE: 10/16/2019

NARRATIVE

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Staff was also reminded to review Quarterly updates regarding Child Care Licensing’s Rules and Regulations on the department's website.

Children are inspected for illnesses as they arrive. A review of medication policy indicated that only prescription medication is administered and only with parent's written permission. The director/assist. director administers the medication and document the dosages, date and time onto a log. Medications are stored in a lock box above the refrigerator in the director's office.

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.

There were no deficiencies cited as a result of this inspection. Notice of Site Visit was given to be posted for 30 days.

Exit interview was conducted, report was read and a copy was provided to the director.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

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