197750069-8-20-2019-12-CC-BREO-BF8NDH-20190820102222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750069
Report Date: 08/20/2019
Date Signed: 08/20/2019 10:22:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	OLD ORCHARD - PEAK PROGRAMS INC		FACILITY NUMBER:	197750069
ADMINISTRATOR:	WEBER, BRANDY		FACILITY TYPE:	840
ADDRESS:	25141 AVENIDA RONDEL		TELEPHONE:	(661) 291-4040
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	39	CENSUS: 0	DATE:	08/20/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Scott Bartholomew and Mary Boyle		TIME COMPLETED:	10:40 AM

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On 8/20/2019 at 8:45 a.m., Licensing Program Analyst (LPA) Brianna Reynoso met with above facility's Director, Mary Boyle. LPA was at the facility to conduct an announced prelicensing inspection as the facility had submitted a new application for a School Age Child Care Center.

At 9:00 a.m., LPA met with owner, Scott Bartholomew.

The facility's hours of operation will be Monday through Friday from 6:30 a.m. to 6:30 p.m. They will provide morning and afternoon snacks, which will be purchased by the facility. Per the Director, the facility will not be transporting school age children in care.

During this inspection, LPA measured the indoor activity space that will be utilized by the facility. The facility will only be using Classroom 25 which is located inside of Corridor G101. The measurements for the classroom are as follows:

Classroom 25: 819 square feet / 35 = 23 children

Per Deo Persaud, Assistant Superintendent for the Newhall School District Business Services, the classroom that will be used by the facility has been granted an occupancy of 30 to 35 children. Based on California Code of Regulations Section 101471, the facility may use the occupancy indicated on the certification statement provided by the school district, and therefore will be granted a capacity of 32 school age children.

The facility will be using the playground on the Old Orchard Elementary School site. The facility is exempt from square-footage requirements for indoor and outdoor activity space, and toilet requirements as they are operating in accordance with Health and Safety Code Section 1596.806.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: OLD ORCHARD - PEAK PROGRAMS INC	FACILITY NUMBER: 197750069
	VISIT DATE: 08/20/2019

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LPA observed the outdoor play area 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 will have access to water through water fountains during outdoor activities. The playground was fenced all around, and no bodies of water were observed. LPA also observed shaded rest areas for the children in care.

LPA observed and inspected three restrooms for the children in care. The two gender separate restrooms were located on the playground, and an additional unisex restroom was located inside of Corridor G101. Each restroom had toilet paper, hand soap, and paper towels accessible to children in care. LPA observed a total of five sinks, six toilets, and one urinal, all of which were in operable conditions. Staff have a separate restroom. Staff members will use the unisex restroom located in the hallway closest to the classroom.

Furniture and equipment were inspected for operable conditions and age appropriateness. Telephone service, heating, lighting and ventilation were evaluated. LPA observed storage space inside of the classroom. Snacks will be stored inside of Classroom 25, and the parent board was observed and located to the left of the classroom entrance. Children will have access to water through water jugs and disposable cups.

LPA observed a First Aid Kit located inside of the classroom. A fire extinguisher (2A10BC) was observed and in operable condition as it had a service tag attached indicating it was last serviced on 7/9/2019. Trash cans with tight lids were observed. The Assistant Director has a current CPR and Pediatric First Aid certification, which expires on 7/2021.

The facility has a current annual certification for the fire alarm system, which was conducted by A & A Fire Protection on 7/22/2019. The certification is proof that the fire alarm system as well as the smoke system is in operable condition. The facility was also reminded this certification must be kept on the premises and readily available for future CCLD inspections.

The facility was unable to test their carbon monoxide detector as they did not have one on the premises. The owner informed LPA he would purchase a plug in carbon monoxide detector. Once purchased, he will submit a photograph as proof of purchase, and a video to verify it is in operable condition.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: OLD ORCHARD - PEAK PROGRAMS INC	FACILITY NUMBER: 197750069
	VISIT DATE: 08/20/2019

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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

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 following was discussed with the Director:

Smoking is prohibited on the premises of a child care center; Earthquake safety and necessity of drills are to be conducted every 6 months and logged; Required forms for children’s files, facility files, staff files, and posting requirements; Fingerprint clearances and the transfer process.

Child Care Advocates:
To sign up for our Quarterly Updates and Provider Information Notices (PINs), please subscribe online: http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe

Based on today's inspection, a license for a School Age Child Care Center with a capacity of 32 will be granted once the following have been completed: The facility submits proof of completion for owner, Scott Bartholomew and Director, Mary Boyle's 16 hours of Preventative Health and Safety training with one hour of child nutrition; proof of carbon monoxide detector; and completion of all pending documents listed on the Notification of Incomplete Application (NOIA).

An exit interview was conducted and a copy of this report was provided to Director, Mary Boyle.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

LIC809 (FAS) - (06/04)

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