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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492785
Report Date: 08/03/2023
Date Signed: 08/03/2023 03:53:41 PM


Document Has Been Signed on 08/03/2023 03:53 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:MONTESSORI OF SANTA CLARITAFACILITY NUMBER:
197492785
ADMINISTRATOR:BRANDY BLACK-PEREAFACILITY TYPE:
840
ADDRESS:27757 BOUQUET CANYON ROADTELEPHONE:
(661) 296-0175
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:20CENSUS: 0DATE:
08/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Bandy Black-PereaTIME COMPLETED:
04:00 PM
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On 8/03/2023 Licensing Program Analyst (LPA)Isabel Ortega met with facility Director Brandy Black-Perea and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA did not observe any children in care. Facility Operates in one classroom referred to as the School Age Program.

There is a total of one classroom, one play yard and an electrical room(locked) utilized for equipment storage and emergency supplies.
Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and AC ventilation were evaluated. LPA observed individual storage with children’s name labeled for children's belongings.
The classroom consists of filtered water in a pitcher and children bring their own personal water bottles, disposable cups are also available.

Age appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, restocked of toiletries and sanitized by school facility’s on-site custodian daily.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2023
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: MONTESSORI OF SANTA CLARITA
FACILITY NUMBER: 197492785
VISIT DATE: 08/03/2023
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An isolation area was inspected, which takes place in the Director’s office. Children have the option for rest time and quiet time if needed.

Facility operates full time during school breaks: Monday through Friday from 7:00 a.m. to 6:00 p.m. During school days facility operates after-school Wednesdays from 1:49 p.m. to 6:00 p.m. and Monday, Tuesday, Thursday, and Friday from first pick up at 2:01 p.m. and second pick up 3:11 p.m. to 6:00 p.m. (Subject to change yearly). Facility provides a P.M. snack for children enrolled.

Licensee had all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, and Earthquake Preparedness Checklist.

First Aid supplies, smoke detectors, carbon monoxide (tested at 2:01 p.m.) are observed to be operating properly. The fire extinguisher (2A10BC) is reading in green and meets the Fire Marshal codes and standards (last serviced 10/04/2022).

Trash cans with tight lids were observed. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. There is hot running water in the kitchen dispenser if needed. The kitchen area is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 7/24/2023 at 10:05 a.m.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
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: MONTESSORI OF SANTA CLARITA
FACILITY NUMBER: 197492785
VISIT DATE: 08/03/2023
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 Food allergies are noted and are posted in the food preparation area and in each classroom.

The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. During outdoor play children are provided with filtered water in personal water bottles brought from home and disposable cups are available during outdoor play. Facility had the water sampled tested for lead on 5/26/2023, facility is providing non-contaminated water for drinking. There is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed in the outdoor play area.



The parent board was reviewed and has all the required forms posted accessible to parents.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

Directors and teachers are currently certified in Pediatric CPR/First Aid which expires until 06/24/2025. Child Care Provider Mandated Reporter (AB1207) training is dated 08/24/2022.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MONTESSORI OF SANTA CLARITA
FACILITY NUMBER: 197492785
VISIT DATE: 08/03/2023
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The following Incidental Medical Services (IMS) were discussed.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and 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/childqanda.htm

All staff are required to take 3-hour Child Care Provider Mandated Reporter training every 2 years. www.mandatedreporterca.com.

Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: MONTESSORI OF SANTA CLARITA
FACILITY NUMBER: 197492785
VISIT DATE: 08/03/2023
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Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000.

For additional information and forms visit our website at: www.cdss.ca.gov

For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

A copy of this report must be made available to the public for 3 years.

Per Title 22 Regulations facility is in compliance, no deficiency will be issued today. An exit Interview was conducted with facility Director Brandy Black-Perea A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5