197750071-10-25-2019-12-CC-TLAN-BHAVLF-20191025163151

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750071
Report Date: 10/22/2019
Date Signed: 10/25/2019 04:32:26 PM

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:	PHILIP MAX SAETA LEARNING ACADEMY HS		FACILITY NUMBER:	197750071
ADMINISTRATOR:	GONZALEZ, NURY		FACILITY TYPE:	850
ADDRESS:	10620 SHERMAN GROVE AVE.		TELEPHONE:	(213) 389-1500
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	30	CENSUS: 0	DATE:	10/22/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Edie Smith		TIME COMPLETED:	12:39 PM

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Licensing Program Analyst (LPA) Lawson met with Edie Smith today for the purpose of a Pre-Licensing Inspection for a Preschool Program. This center is located on the Foursquare Church Campus. Center is located further back from the church behind a white gate. The gate equipped with a gate code with a camera. The center will be utilizing the building on the right side. Parents will have a code to enter through the main gate, once inside the center, parents will physically sign in and out. LPA was led on a tour of the center which consist of 3 classrooms (two main classrooms and a small STEM activity room) and the outside area. The hours of operation: Monday through Friday 8:15 AM to 2:30 PM.

During this Pre-Licensing inspection, LPA measured 3 classrooms (2 Classrooms and 1 STEM Activity Room) and the outside play area. Measurements were as follows:

Classrooms:

Classroom #1: 17.00 x 32.26 = 548.42/35 = 16

Classroom # 2: Main Area (11.06 X 25.60 = 283.13) + Area near STEM Room (10.00 X 10.99 = 109.88) + Area Near Exit (17.10 x 12.19 = 208.48) = 601.49/35 = 17

STEM Room (Classroom #3): 10.07 x 13.06 = 131.55/35 = 4

Outdoor Measurements:

Play Yard: Main Play Area (38.09 X 39.03 = 1486.65) + Concert Area (5.11 x 37.02 = 189.17) = 1675.82/75 = 22

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: PHILIP MAX SAETA LEARNING ACADEMY HS	FACILITY NUMBER: 197750071
	VISIT DATE: 10/22/2019

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**Classrooms were equipped with age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and safe and free of any hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings will kept in cubbies along the wall as you enter classrooms. Drinking water is available inside the classroom in the form of a water cooler and disposable cups. There are trash cans with lids present in both classrooms. Each classroom has an area for stackable cots. Linens and bedding will be stored individually so that each child's bedding is identifiable. Each cot will be equipped with a sheet to cover the cot, bedding and linens will be laundered weekly and as needed. Extra bedding will be kept on site. Flooring was inspected for cleanliness, and good repair.

**Classrooms have separate entrances for parent's drop off and pick up.

**The children's bathrooms are located within the classrooms, each bathrooms contains 2 toilets and 2 sinks. The staff bathroom is located inside the Site Director's Office. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate.

**The Site Director's Office will be used as an isolation room and the staff bathroom will be used as an isolation bathroom.

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes foam under climbing structure for cushioning material and there is shade structure present. There is a Large Pirate Ship play structure (jungle gym) which was securely anchored. LPA observed the white vinyl fencing surrounding the play area the outdoor activity area, the gate was locked during this inspection. The cemented are will be utilize for art and table activities. Staff will bring drinking water outside for children (igloo and disposable cups). There are no bodies of water observed on the premises.

**The Parent Board (located in each classroom) contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid (expires 08/21/2021).

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: PHILIP MAX SAETA LEARNING ACADEMY HS	FACILITY NUMBER: 197750071
	VISIT DATE: 10/22/2019

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**Food preparation Area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Center will supply breakfast, lunch and snack for the children. Hot meals will be provided by the Main Office daily. The meals are stored either in the fridge or warmer until it needs to be served. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children and away from food.

LPA observed two fully stocked first aid kits; fully charged fire extinguishers; carbon monoxide detectors and smoke detectors throughout the center. Teachers, along with the parent, will be trained by a nurse if there is a need for medication.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers. 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 available at: http://www.ada.gov/childqanda.htm - Center will not provide IMS at this time; however, if the need arises there is a designated mini-fridge for medicine and a plan for training.

Applicants were reminded that prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer using form LIC 9182.

Classroom measurements = 37

Toilets and Sinks = 60
Outdoor Play Yard = 22
Fire Clearance = 30
Requested Capacity is 30

Capacity will be approved for 30

Exit interview conducted and a copy of this report was read and provided to Edie Smith.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

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