197750042-1-19-2022-12-CC-DMAX-CATVDX-20220119152128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750042
Report Date: 01/19/2022
Date Signed: 01/19/2022 03:21:40 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:	LIFE SOURCE PRESCHOOL		FACILITY NUMBER:	197750042
ADMINISTRATOR:	CULPEPPER, DEBERAE		FACILITY TYPE:	850
ADDRESS:	44339 BEECH AVE		TELEPHONE:	(661) 579-2970
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	12	CENSUS: 0	DATE:	01/19/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	Deberae Culpepper, Applicant/Licensee and Colleen Calloway, Program Director		TIME COMPLETED:	02:00 PM

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Licensing Program Analyst (LPA) Maddox met with Deberae Culpepper, Applicant/Licensee and Colleen Calloway, Program Director today for the purpose of increasing the capacity of the PS from 12 to 60. Together we toured and measured 7 classrooms. This PS program is located on the grounds of Life Source Charter School (TK to 8th grade) and will cater to children ages 3 to 4 yrs of age. Center also has a licensed Pre-school located down the street (44709 BEECH AVE, Lancaster, CA 93534). Days/hours of operation will be Monday through Friday from 6:00am to 6:00pm.

INDOOR ACTIVITY SPACE: Classrooms toured today are set up for School age children, before center accepts PS children, the classrooms will need to have age appropriate toys and equipment and materials.

The isolation area (located in the office area) will be equipped to isolate and care for any child who becomes ill during the day, the staff bathroom is designated as the isolation bathroom.

Meals:

Center will provide breakfast, snack, lunch. Meals will be delivered daily from the cafeteria to the classrooms. an outside source.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

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: LIFE SOURCE PRESCHOOL	FACILITY NUMBER: 197750042
	VISIT DATE: 01/19/2022

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The PS component is requesting to occupy the following classrooms: Room #s 4,14, 16,17, 20, 21, and 22. These are the measurements:

# 4 - 29 X 20 = 580/35 = 17 children
#14,16 & 17 - 39 X 23= 897/35 = 25 in each classroom
# 20 - 27 X 16 = 432/35 = 12 children
# 21 & 22 - 17 X 14 = 238/35 = 7 children

Total Indoor capacity with the additional classrooms: 118 (not including the current capacity of 12). Total capacity for all classrooms 130

Outdoor Space Preschool:
There are permanent shaded structures on the play yard. During this inspection, the outside area was not sectioned off from the elementary school yard. Administrator will forward outside sketch with measurements.

Bathrooms:
There's 1 bathroom designated for the current PS license (1T/1S) ; Room # 20 has its own bathroom (1T/1S); There is a "Jack N Jill" bathroom between Room's 21 & 22 (1T/1S); Rooms # 4,14, 16 & 17 will use the bathrooms located in the Auditorium (children will have to be sectored to these bathrooms). There are 2 separate bathrooms, 1 bathroom has 2 urinals, 2 individual stalls, and 3 sinks; the second bathroom has 4 stalls and 3 sinks (sinks for washing hands are readily available). Total capacity for the bathrooms located in the Auditorium is 90 plus the 3 additional bathrooms is 135.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

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: LIFE SOURCE PRESCHOOL	FACILITY NUMBER: 197750042
	VISIT DATE: 01/19/2022

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LPA ensured the toilets flushed properly and are reachable for children. The restroom has adequate toilet paper and paper towels available, were found to be clean and sanitary.

Center has a separate staff bathroom, 1 bathroom is in the Administration Office and the 2nd Staff bathroom is in the front office, either bathroom can be designated as an isolation bathroom.

Sign-in and Out Procedure: Currently the sign in and out area is in the front main office.

Napping: Center will use mats for sleeping. Floor mats used for napping shall be: Constructed of foam at least 3/4-inch-thick; Wiped with a detergent/disinfectant after each usage; Maintained in a safe condition with no exposed foam. Each cot or mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child. Bedding shall be individually stored so that each child's bedding is identifiable, and no child's used bedding comes into contact with other bedding.

HEALTH RELATED SERVICES:

Medications will be kept in a locked box or cabinet. There will be 1 person designated to dispense medications and 1 back up person. A refrigerator shall be used to store any medication that requires refrigeration.

Center has a developed plan to implement and to record the administration of prescription medication and to inform the child's authorized representative daily when such medications have been given.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

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: LIFE SOURCE PRESCHOOL	FACILITY NUMBER: 197750042
	VISIT DATE: 01/19/2022

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LPA observed fully equipped first aid kits in each classroom. The Carbon Monoxide detector is integrated within the fire system. There are fire extinguishers throughout the campus.

Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances will be stored inaccessible to children. Center has a cleaning crew that cleans and disinfects all classrooms.

Incidental Medical Services was discussed.

Due to the COVID-19 pandemic, Center has COVID signs posted throughout the campus. There will be a Parent Board in each classroom.

The following are needed before the capacity will be granted:

· Each classroom designated for the PS children will need to be set up with age appropriate toys and equipment

· Measurements needed for the outside play space

Fire clearance has been received for a capacity of 60 children. After the aforementioned corrections are received, center will be licensed for 60 children, applicant will request a second capacity increase to accommodate the total capacity of 130. Exit interview was conducted, copy of this report was read, signed, and printed out for Applicant.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

LIC809 (FAS) - (06/04)

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