<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750071
Report Date: 05/01/2023
Date Signed: 05/01/2023 11:27:25 AM


Document Has Been Signed on 05/01/2023 11:27 AM - 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:PHILIP MAX SAETA LEARNING ACADEMY HSFACILITY NUMBER:
197750071
ADMINISTRATOR:GONZALEZ, NURYFACILITY TYPE:
850
ADDRESS:10618 1/2 SHERMAN GROVE AVE.TELEPHONE:
(213) 389-1500
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY:30CENSUS: 13DATE:
05/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:23 AM
MET WITH:Adriana HermosilloTIME COMPLETED:
11:35 PM
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 5/1/2023, Licensing Program Analyst (LPA) Carol Heath met with the Site Supervisor, Adriana Hermosillo, for the purpose of conducting an unannounced 5 year required inspection. This Head Start Program is located on the Foursquare Church Campus. The Center is located further back from the church behind a white gate. LPA disclosed the purpose of the inspection and was granted entry. LPA toured and inspected the preschool in accordance with the facility sketch. This Head Start Program will occupy 3 classrooms (two main classrooms and a small STEM activity room) and the outside area. The hours of operation: Monday through Friday, 8:00 AM to 2:15 PM. Upon arrival, LPA observed 1 classroom in use with a total of 13 preschool children and 3 teachers and supervisor on the premises. Incidental Medical Services (IMS) were discussed. The Center provides IMS at this time. There is a child who needs IMS service.

LPA toured and inspected the 1 classroom. Furniture and equipment were inspected for age appropriateness and good repair. The Center provides potty training. There were no changing tables present; Site Supervisor mentioned that diaper changing is done standing. The children's bathrooms are located within the classrooms; each bathroom 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. The toilets and sinks are functioning properly and age-appropriate.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/01/2023
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 5


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: PHILIP MAX SAETA LEARNING ACADEMY HS
FACILITY NUMBER: 197750071
VISIT DATE: 05/01/2023
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
LPA observed a sufficient quantity of cots available for napping children. Bedding and linens were individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. The sheets and blankets are washed weekly (sent home with parents to wash or staff washes after hours), and cots are sanitized daily.
The telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings in each classroom. LPA observed age-appropriate toys and materials. 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.
The food preparation Area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination, and storage. The Center will supply breakfast, lunch, and snacks 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 a fully stocked first aid kit, fully charged fire extinguishers, and carbon monoxide detectors throughout the center. There is a Fire Drill/Earthquake log that is current and posted. LPA also observed a current Roster available.
Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Site Supervisor administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily. Medication is properly labeled and stored in its original container. There are currently 1 child in care with IMS needs. The Site Director's Office will be used as an isolation room, and the staff bathroom will be used as an isolation bathroom.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: PHILIP MAX SAETA LEARNING ACADEMY HS
FACILITY NUMBER: 197750071
VISIT DATE: 05/01/2023
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
Sign-in and out sheets were reviewed. Teacher to child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if the basic needs of children were met and appropriate. LPA observed a parent board consisting of licensing-required postings. Sign-in and out sheets were reviewed.
Children's records and staff records were reviewed. The Parent Board (located in each classroom) contains all documents that are required to be posted according to Title 22 Regulations. Staff is certified in Pediatric CPR and First Aid (expires 06/21/23). Mandated Reporter expires 02/21/2020.
LPA observed and reviewed 6 children’s files. The files contain all documents and parent signatures.
The outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. The Center utilizes foam under the climbing structure for cushioning material, and there is a 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 and the outdoor activity area; the gate was locked during this inspection. The cemented area will be utilized 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.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: PHILIP MAX SAETA LEARNING ACADEMY HS
FACILITY NUMBER: 197750071
VISIT DATE: 05/01/2023
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
The following general information was discussed during this inspection:

The 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.
Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, child care providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. Staff was informed that they needed to take mandated reporter training.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: PHILIP MAX SAETA LEARNING ACADEMY HS
FACILITY NUMBER: 197750071
VISIT DATE: 05/01/2023
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
Safe Sleep Information: California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare 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 of a criminal record clearance from one state-licensed facility to another using form LIC 9184

No deficiencies are being cited at this time; the facility complies with Title 22

Exit interview conducted with Site Supervisor. A copy of this report is discussed and left with Site Supervisor, Adriana Hermosillo.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5