197750006-3-12-2020-12-CC-MJAA-BMMRME-20200312130836

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750006
Report Date: 03/12/2020
Date Signed: 03/12/2020 01:08:46 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:	SUNSHINE PINETREE		FACILITY NUMBER:	197750006
ADMINISTRATOR:	CINDY WOOD		FACILITY TYPE:	840
ADDRESS:	29156 N. LOTUSGARDEN DRIVE		TELEPHONE:	(661) 904-7394
CITY:	CANYON COUNTRY	STATE: CA	ZIP CODE:	91351
CAPACITY:	75	CENSUS: 39	DATE:	03/12/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Tiffany Shroyer, Director		TIME COMPLETED:	01:20 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) Ayala met with Director Tiffany Shroyer, today for the purpose of conducting an unannounced Annual/Random inspection. Present today were 39 school age children and 4 teachers. Director led LPA Ayala on a tour of the facility. LPA inspected inside and outside of the facility. The hours of operation: Monday through Friday 6:30 am to 7:25 am and in the afternoon 2:15 pm to 6:30 pm. On minium days this facility will open from 11:45 am to 6:30 pm. LPA observed classroom #19 and #20, the classroom were observed to be clean and safe and free of any Health or safety hazards. LPA observed age appropriate furniture, equipment, toys and materials. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the wall as you enter classrooms. Both classrooms were fully carpeted and in clean conditions. Each classroom has sink located in the classroom which will be utilized by the children for drinking water and for washing of hands. Each classroom has storage cabinet in which are art supplies will be kept. Each classroom has tightly sealed trash can. Smoke detectors, carbon monoxide and fire extinguishers were observed and were in operational condition during the time of the inspection. Parent sign in and out sheet are digital in classrooms #19 and #20 .This facility provides light snacks to children menus are posted and visible. The Parent Boards (located in room #20) contained required posting documents; all documents that are required to be posted according to Title 22 Regulations. A sampling of Children's records were reviewed as part of this inspection. Staff files were reviewed and complete. Staff are certified in Pediatric CPR and First Aid (exp 09/14/2020), children files reviewed today were complete including current/required immunization's. Disaster drills are conducted every monthly, last drill was conducted on 02/20/2020.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SUNSHINE PINETREE	FACILITY NUMBER: 197750006
	VISIT DATE: 03/12/2020

NARRATIVE

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There is a separate area for isolation and care of ill children in the director's office room 20 the glass/cubbie partition. There will be cots available for children that are ill or in need to nap. All sick children will be taken to the director's office located in room #20. First Aid Kit is kept on the premises and located in each classroom.

Outdoor play equipment was inspected for health and safety. Playground equipment: climbing structures, slides and other large play equipment were found to be securely anchored. There was grass cushioning material underneath and around the surrounding perimeter of the play structure. Children will also have access to grass area field which is fenced in. The surface of the outdoor activity space is in safe condition and free of hazards. LPA observed drinking fountains outside on the premises of the property, drinking water will be readily available to children on the play yard.

The facility has an outdoor waiver for the restrooms. All waivers are posted in a visible area. There are restrooms on premises for girls and boy. The girls’ restroom has two sinks and five toilets. All equipment in the restroom was in operational condition. The boy restroom has 2 sinks and four urinals and one toilet. The restrooms that the children will utilize are approximately 50 ft way from classrooms. Director stated staff provide supervision when children go to the restroom.

Facility has a current IMS plan in place. All medications are stored in room #20 in directors off limits office area (placed in a locked box), and are inaccessible to children in care. Medication is administered only with parent's written permission and doctor's note. The director ensures medication was observed and there were no expired medication. Medication dosage and other information regarding the medication is kept stored individually with child's name along with the medication.

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 -

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SUNSHINE PINETREE	FACILITY NUMBER: 197750006
	VISIT DATE: 03/12/2020

NARRATIVE

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§1596.8662 On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years. Staff have completed training and are due for renewal 09/12/2020.

§1596.7995 (a) (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.

**Update Licensing forms with the new Palmdale Regional Office contact information.

There were no violations noted as a result of this inspection, Center is operating in accordance to Title 22 Regulations.

An exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

LIC809 (FAS) - (06/04)

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