197418892-6-9-2023-12-CC-AALH-CSMPZK-20230609114540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418892
Report Date: 06/09/2023
Date Signed: 06/09/2023 11:45:51 AM

Document Has Been Signed on 06/09/2023 11:45 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:	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: 0	DATE:	06/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Director Sam Ottman		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 06/09/2023 Licensing Program Analyst (LPA) Andrew Alemoh 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 0 children and director Sam Ottamn . The facility operations from 7AM - 6PM. (Morning session, 7:00AM to 8:15AM before elementary school begins and in the afternoons, 2:00pm to 6:00 pm), however Summer Camp hours are 7AM to 6PM. Front/Kindgergaten Rm: LPA observed 3 tables for the children to sit, play and eat. There are cubbies for children to place their belongings. A 2A10BC fire extinguisher was observed to be in operation. First aid medical bag with supplies readily available. LPA observed educational material for the children such as: books, games, arts and crafts. 1st Grade Rm: LPA observed 6 tables for the children to sit, play and eat. A water dispenser was observed to be in the classroom. There are cubbies for children to place their belongings. A 2A10BC fire extinguisher was observed and in operation. LPA observed educational materials such as books, magnets, and arts and crafts.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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: SUNSHINE-STEVENSON RANCH	FACILITY NUMBER: 197418892
	VISIT DATE: 06/09/2023

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2nd/3rd Rm: LPA observed 4 tables for children to sit, play and eat. A water dispenser was located in the classroom with disposable cups. First aid medical bag was observed in the cabinets. There are educational materials for the children to enjoy such as arts and crafts, blocks, books and toys.

4th/6th Rm: LPA observed 6 tables for children to sit, eat and play. There are cubbies for children to place their belongings. A water dispenser with disposable cups. LPA observed arts and crafts materials, books and toys for the children to pay. First aid medical bag was observed in the cabinet. A fire extinguisher 2A10BC was observed to be in fully operation. A trash can with a tightly fitted trash bag was observed.

Storage Rm: LPA observed the storage room to contain 2 bathrooms (boys/girls). Children use the storage room for the bathroom access only. There is a microwave as well as sink that is used for the dishes. A fire extinguisher 2A10BC was observed to be in operation. LPA observed ten 1 gallon water jugs. Arts and crafts supplies, paint and extra materials for children were observed.

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 in the storage room. 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). There are locked cabinets in the bathroom that contain cleaning supplies. 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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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: SUNSHINE-STEVENSON RANCH	FACILITY NUMBER: 197418892
	VISIT DATE: 06/09/2023

NARRATIVE

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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.

Staff present have current pediatric CPR expires 04/27/25 . Sign in/out is done electronically (via Kangaroo Time). There is a fully stocked emergency supply cabinet (storage rm, 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 11/08/24. Staff was reminded Mandated Reporter training must be completed every two years by staff and volunteers.

Staff was also reminded to review Quarterly updates regarding Child Care Licensing 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 in the director's office.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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: SUNSHINE-STEVENSON RANCH	FACILITY NUMBER: 197418892
	VISIT DATE: 06/09/2023

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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) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC809 (FAS) - (06/04)

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