263808973-8-26-2022-12-CC-SMOA-CHNPDA-20220826111312

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 263808973
Report Date: 08/26/2022
Date Signed: 08/26/2022 11:13:43 AM

Document Has Been Signed on 08/26/2022 11:13 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:	BRIDGEPORT ELEMENTARY PRESCHOOL		FACILITY NUMBER:	263808973
ADMINISTRATOR:	CLARK, DON		FACILITY TYPE:	850
ADDRESS:	231 KINGSLEY AVE		TELEPHONE:	(760) 932-7441
CITY:	BRIDGEPORT	STATE: CA	ZIP CODE:	93517
CAPACITY:	15	CENSUS: 0	DATE:	08/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Lisa Kelly Principal		TIME COMPLETED:	11:23 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	Licensing Program Analyst (LPA) Steven Montoya met Principal Administrator Lisa Kelly for the purpose of conducting an unannounced annual inspection. LPA toured and inspected all areas according to the facility sketch (1 classrooms), 0 staff, Principal Administrator, no teachers and 0 children during inspection. Staff reviewed 5 children files for reviewed. Per Principal Administrator, Facility hours of operation are Monday through Friday, Hours of Operation: 7:30- 4:00pm LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and safe. Telephone service was verified as well as adequate drinking system. Children's belongings are kept in cubbies as you enter classrooms. Drinking water is available inside the classroom in the form of a water fountain. Centers' last Emergency Disaster Drill was conducted 10/2019. LPA observed fully charged fire extinguishers last service as of 08/2023, Carbon monoxide detectors and Fire Alarm are in operable and working condition. Classroom contains a first aid kit. The children's bathroom is located inside the classrooms. There is one bathrooms in the classroom and it contains 1 toilet and 1 sink. The staff rest-room is located in the main office area. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are in functioning condition and age appropriate.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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: BRIDGEPORT ELEMENTARY PRESCHOOL	FACILITY NUMBER: 263808973
	VISIT DATE: 08/26/2022

NARRATIVE

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Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes pads-under climbing structures for cushioning material and there is enough and adequate shade available.

Facility Roster: LPA observed Child Care Facility Roster. Per Licensing Information System, facility annual fees were current.

Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is not current. there are no current facility earthquake/fire drills documents observed during the time of this inspection.

The following information was discussed with the licensee:

Mandatory Forms for the children’s files and provider’s files.
Requirements for fire drills, earthquake drills, and documentation for both.
The role and responsibilities of being a mandated reporter were discussed.
The licensee is reminded that 100% supervision is required for children at all
times.

Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.

Principal was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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: BRIDGEPORT ELEMENTARY PRESCHOOL	FACILITY NUMBER: 263808973
	VISIT DATE: 08/26/2022

NARRATIVE

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Administrator was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B

The Administrator was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

Criminal Record Statement: Administrator was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Documentation:

CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (04/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.

Immunization: The licensee has the required immunization. The licensee provided a written statement declining the influenza vaccination.

Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and need to renew by 03/29/2023

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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: BRIDGEPORT ELEMENTARY PRESCHOOL	FACILITY NUMBER: 263808973
	VISIT DATE: 08/26/2022

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Administrator was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates informatioww.childcareadvocatesprogram@cdss.ca.gov

Adminstrator was advised the Regional Office has an on Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

LPA provided consultation during the inspection.

No Deficiencies cites

Exit interview conducted and inspection report, appeals rights and notice of site visit was reviewed with the administrator Lisa Kelly.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

LIC809 (FAS) - (06/04)

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