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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750063
Report Date: 06/29/2021
Date Signed: 06/29/2021 01:12:22 PM

Document Has Been Signed on 06/29/2021 01:12 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BLUE SKY KIDSFACILITY NUMBER:
197750063
ADMINISTRATOR:DENKOVSKI, SANDRAFACILITY TYPE:
840
ADDRESS:24800 PEACHLAND AVETELEPHONE:
(661) 251-3182
CITY:SANTA CLARITASTATE: CAZIP CODE:
91321
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 32DATE:
06/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Nayeli Sanchez, Site DirectorTIME COMPLETED:
01:35 PM
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On 06/29/2021, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced Required 1 Year inspection. Upon arrival, LPA met with site director who guided LPA on a tour of the facility. This facility is located on Peachland Elementary School grounds in classrooms 25, 27 and 28. The facility operates Monday through Friday from 6:30 A.M. to 6:30 P.M. LPA observed 32 children in care with 3 staff. All staff members are cleared and associated to the facility.

Furniture and equipment were inspected for operable conditions and age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. Children have access to water through water pitchers and disposable water cups located inside of each classroom and children bring their own water bottles that are labeled. The facility uses room 21 to isolate sick children. Children do not nap at the facility.

Age appropriate sinks and toilets were inspected. Toilets flush properly; toilets and sinks are reachable by the children. LPA observed all toilets and sinks were found to be in operable condition, and met the Title 22 requirements. LPA observed staff restrooms which is located across from room 28.

First Aid supplies, smoke detector, carbon monoxide and fire extinguishers were observed and in operable condition. Trash cans with tight lids were observed. The facility provides a morning snack, an afternoon snack, children are able to bring their own lunch from home. Food was inspected and it was properly labeled, stored, and within expiration date.

The kitchen area is located in room 28 and is adequately equipped, clean, and free from hazards. Menu is posted, dated, and accessible for parent’s review. LPA observed an allergy list posted in the kitchen area near the refrigerator. Children's medication is stored in a locked cabinet near directors desk.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2021
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: BLUE SKY KIDS
FACILITY NUMBER: 197750063
VISIT DATE: 06/29/2021
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The facility uses the elementary school playground and the elementary school bathrooms. The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, conditions and age appropriateness. Climbing structures, slides, and play equipment were found to be securely anchored with resilient cushioning material underneath and around the perimeter. Children have access to water through water pitchers and disposable cups during outdoor activities and bring their own water bottles that are labeled. The playground is fenced all around, and no bodies of water observed in the outdoor play area. The playground area has a shaded rest area for the children.

Children and staff files were reviewed and found to be complete. The facility roster and fire drills were up to date. The facility director has a current CPR and Pediatric First Aid certification, which expires on 02/01/2023. During the inspection LPA observed adequate teacher child ratio in each classroom. The parent board was reviewed and had all of the required forms posted and accessible to parents.

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

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

The director was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
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: BLUE SKY KIDS
FACILITY NUMBER: 197750063
VISIT DATE: 06/29/2021
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Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at
childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The above facility was found to be in substantial compliance, and no deficiencies were cited during today’s inspection.

An exit Interview was conducted, a copy of this report, and notice of site visit was provided to Director
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
LIC809 (FAS) - (06/04)
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