197750069-8-4-2020-12-CC-DMAX-BS6SHK-20200804135338

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750069
Report Date: 08/04/2020
Date Signed: 08/04/2020 01:54:09 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:	OLD ORCHARD - PEAK PROGRAMS INC		FACILITY NUMBER:	197750069
ADMINISTRATOR:	BOYLE, MARY		FACILITY TYPE:	840
ADDRESS:	25141 AVENIDA RONDEL		TELEPHONE:	(661) 291-4040
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	32	CENSUS: 0	DATE:	08/04/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Scott Bartholomew		TIME COMPLETED:	11:45 AM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On 8/20/2019 at 8:45 a.m., Licensing Program Analyst (LPA) Donna Maddox met with above facility's Owner, Scott Bartholomew. 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.

The facility's hours of operation will be Monday through Friday from 7:30 a.m. to 5:30 p.m. They will provide all snacks for children including breakfast and lunch.

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 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 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.

PA 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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2020

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 3

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: OLD ORCHARD - PEAK PROGRAMS INC	FACILITY NUMBER: 197750069
	VISIT DATE: 08/04/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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 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. There is also a working carbon monoxide detector present.

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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: OLD ORCHARD - PEAK PROGRAMS INC	FACILITY NUMBER: 197750069
	VISIT DATE: 08/04/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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: Proof of current CPR and First Aid training; Proof of Health and Safety Training including Lead poisoning training.

An exit interview was conducted and a copy of this report will be emailed to Owner, Scott Bartholomew.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3