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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750022
Report Date: 01/31/2020
Date Signed: 01/31/2020 03:43:18 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:ANTELOPE ELEMENTARY SCHOOLFACILITY NUMBER:
197750022
ADMINISTRATOR:LUNA, JESUSFACILITY TYPE:
850
ADDRESS:37237 NORTH 100TH STREET EASTTELEPHONE:
(661) 944-2148
CITY:LITTLEROCKSTATE: CAZIP CODE:
93543
CAPACITY:24CENSUS: DATE:
01/31/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jesus Luna, DirectorTIME COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA's) Smith, Ayala and King-Lewis met with Director, Jesus Luna today for the purpose of conducting a Case Management capacity increase from 24 to 48 Preschool children. This center is located on a public school site Antelope Elementary School and belongs to Keppel Union School District. There is physical separation between the public school and the child care center. The Center has relocated prior classroom into 2 bungalow classrooms. There are 2 classrooms that will be used for the preschool, room 1 and 2. LPA's measured classrooms # 1 and 2.

Classroom 1 has 2 toilets and 3 sinks inside classroom. Toilets and sinks are functioning properly and are age appropriate. Staff use a separate bathroom located across the yard.

Classroom 2 has 2 toilets and 3 sinks inside classroom. Toilets and sinks are functioning properly and are age appropriate.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: ANTELOPE ELEMENTARY SCHOOL
FACILITY NUMBER: 197750022
VISIT DATE: 01/31/2020
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Today's measurements were as follows:

CLASSROOM 1 38 X 23 = 874 - 32.69= 841.31/35 EQUALS 24
CLASSROOM 2 39.01 X 23 = 897.23 - 20.14= 877.09/35 EQUALS 25

Fire Clearance has been received to add the classrooms 1 and 2, changing the total capacity to 48 on 10-02-19.
Center now occupies Rooms #1 and #2.

**The outdoor play area is toured and yard is completely fenced. Although the classroom location has changed, the center still occupies the same outdoor play yard and continues to use an alternated outdoor play time for the Preschools and the Kindergarten children.

An exit interview was conducted, copy of Notice of Site Visit and a copy of this report provided to Director, Dr. Luna.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2020
LIC809 (FAS) - (06/04)
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