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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750009
Report Date: 08/24/2023
Date Signed: 08/24/2023 11:35:44 AM


Document Has Been Signed on 08/24/2023 11:35 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:CCRC EHS LPCFACILITY NUMBER:
197750009
ADMINISTRATOR:ZAMORANO-PEDREGON, BEATRIZFACILITY TYPE:
830
ADDRESS:2320 EAST AVE RTELEPHONE:
(818) 717-1000
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY:52CENSUS: 7DATE:
08/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:41 AM
MET WITH:Donald BakeerTIME COMPLETED:
12:00 PM
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On 8/24/2023, Licensing Program Analyst (LPA) Carol Heath met with the Lead Teacher Myra Medrano, to conduct an unannounced Annual inspection of the infant program. According to Myra, the center Director Rosa Ayala Lopez is sick today. LPA disclosed the purpose of the inspection and was granted entry to the facility. The Center will also incorporate a Toddler option. Each component will maintain a physical separation (indoors and outdoors) at all times. The center consists of 4 classrooms. There are only 2 classrooms operating at this time. The Center will operate Monday through Friday, 7:30 am to 4:30 pm. The CCRC Infant/Toddler/Toddler Center is located on the left side, and Living Praise Early Learning Academy is on the right. During today’s inspection, LPA observed 7 toddlers and 7 teachers and 1 classroom aid in the Infant room to provide care and supervision. Incidental Medical Services (IMS) were discussed.

The center is clean, safe, sanitary, and in good repair; there are no potentially hazardous areas observed (passageways), floors are clean and safe, cleaning compounds are inaccessible, poisons are locked, furniture and equipment are in good condition, free of sharp, lose or pointed parts, including cribs, cots, changing table and feeding chairs, no insects or flies observed, play equipment are age appropriate. Each Infant/Toddler has its cubby, trash cans have tight-fitting lids, drinking water (individual cup-labeled), no toxic materials observed, no fireplace, and window screens in good repair. LPA observed the carbon monoxide, Fire Extinguisher, and smoke detector in working condition.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/24/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC EHS LPC
FACILITY NUMBER: 197750009
VISIT DATE: 08/24/2023
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There is a working telephone on the premises, an isolation area for ill Infant/Toddlers in the office area, room temperature is comfortable, First Aid Kit observed, sign-in/out observed (electronic), no smoking on the premises.
Physical Plant: No firearms on the premises. Disinfectants, cleaning solutions, poisons, and other items that are dangerous to Infants/toddlers are inaccessible (top cabinet). LPA observed that the fire extinguisher (2A10BC) and smoke detectors are in operable condition (7/11/2023). The facility has one or more carbon monoxide detectors that meet statutory requirements. The changing table is within arm's reach of the sink.
Napping: LPA observed cots in a safe condition, cribs are in regulation (meets the requirements of 101439.1(a)-(f), no pillows, crib bumpers, loose bedding), sanitize after each use, cots spaced to have access to a safe walkway, bedding is not in contact with other bedding.
Restrooms: Each classroom has access to 1 bathroom, which contains 2 toilets and 2 sinks in each, and also has a diaper changing table within arm's reach of a sink. Staff bathrooms are in an adjacent building. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper, and paper towels readily available. The toilets and sinks are functioning properly.
Outdoor: There are 2 outside play yards. There is a swimming pool located in front of classrooms #1 and #2 with regulated 5 ft. fencing, which includes a spring closure on the gate. The Center has a shaded area and a playground free from hazards and debris, The play structure has cushion material (grass). The surface of the outdoor activity space is maintained in a safe condition and free of hazards. There is no high climbing equipment, swings, or slides on the premises for Infants/Toddlers. Play yard #1 (located in front right will not be in operation at this time. It will be use for the preschool children). Play yard #2 is located at the f of front left for infant/toddler at this facility.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC EHS LPC
FACILITY NUMBER: 197750009
VISIT DATE: 08/24/2023
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Health-Related Services: Medications, when used, are inaccessible to children (locked in kitchen refrigerator); child name and date on medication; the parent has written consent as required. LPA observed 3 children have IMS.
Food Service: There are refrigerators located in each classroom; however, CCRC has its food program, which will deliver breakfast, lunch, and snacks daily. Some snacks will be kept on the premises.
Staff Records: LPA reviewed 5 files for staff.
Children Records: LPA observed that 5 children's files and the records were found to be in order.
Facility Records: LPA observed the Roster to be complete and current, and fire, and earthquake drills are conducted monthly. The facility has an Infant/Toddler/Toddler individual feeding plan, an Infant/Toddler/Toddler Needs and Services Plan, and a Sleep Plan for each Infant/Toddler/Toddler.
Supervision: LPA observed that Infant/Toddler/Toddler/child is not left without the supervision (visual) of a teacher at any time, LPA observed that the facility complies with the staff-Infant/Toddler/Toddler ratio (one teacher-four Infant/Toddler/Toddlers in attendance).
Other: Telephone service, heating, lighting, and ventilation were evaluated.
· The isolation area for sick children is located in the Director’s office.
· A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director and other administration staff administer medication and document the dosage, date, and time on a log. Medication is brought and taken home by the parents daily. Medication is properly labeled and stored in its original container.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC EHS LPC
FACILITY NUMBER: 197750009
VISIT DATE: 08/24/2023
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The 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.
Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare 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.
All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CCRC EHS LPC
FACILITY NUMBER: 197750009
VISIT DATE: 08/24/2023
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Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of the report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt. Staff is aware of the required forms for children's files and forms that shall be posted after licensure.
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.
Parent Board contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid. The in/out process was reviewed and observed. There is a fully stocked first aid kit available and a fully charged fire extinguisher and carbon monoxide detectors in place. The fire Drill/Earthquake log is posted.

No deficiencies are being cited at this time; the facility complies with Title 22


Exit interview conducted with Director. A copy of this report is discussed and left with the Director, Donald Bakeer.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC809 (FAS) - (06/04)
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