360908874-9-29-2022-12-CC-EROZ-CJR387-20220929180105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 360908874
Report Date: 09/29/2022
Date Signed: 09/29/2022 06:01:34 PM

Document Has Been Signed on 09/29/2022 06:01 PM - 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:	VICTOR VALLEY CHRISTIAN PRESCHOOL		FACILITY NUMBER:	360908874
ADMINISTRATOR:	ROSE SANTIAGO		FACILITY TYPE:	850
ADDRESS:	15260 NISQUALLI ROAD		TELEPHONE:	(760) 241-7395
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92395
CAPACITY:	114	CENSUS: 32	DATE:	09/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Rose Santiago		TIME COMPLETED:	01:00 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 09/29/22 at 10:01 a.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced Annual Required inspection at the above Facility to assess the Center's operation of their Program and current physical plant status. Also, to evaluate the Center's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. The LPA met with the Center's Director, Rose Santiago and stated the purpose for the inspection and provided a copy of the Entrance Checklist form, LIC 125. Ms. Santiago provided the Facility children roster and Personnel Report (LIC 500). The Center maintains on file a current Designation of Facility Responsibility (LIC 308), Sign in and Sign Out Rosters, current Parent Handbook. At 10:40 a.m. LPA Rodriguez along with Ms. Santiago conducted a walk trough of the inside and outside of the Facility. The facility license is posted on a prominent place of the Center. During the walk through/inspection of the Facility the LPA discussed observations of Title 22 requirements. The Center is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. First aid kits are available and complete (inaccessible to children/infants.) The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Center conducts and records emergency disaster drills. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children. Furniture and equipment were inspected for age appropriate and observed to be in good repair and defects free. Sign in/out rosters, telephone service, heating, lighting and ventilation were evaluated and no defects were noted. There are clean safe and sanitary individual space/cubbies with children's names. The facility utilizes a designated isolated area to isolate ill children.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

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: VICTOR VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 360908874
	VISIT DATE: 09/29/2022

NARRATIVE

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The toys and material use for instructions meet regulatory requirements. The trash cans contain tight lids. All toilets, hand washing, and bathing facilities are in safe and sanitary operating condition..

The outdoor play areas were noted free of hazards. Playground items are properly secure and free of loose or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Climbing structures are age appropriate, play equipment is properly securely and anchored with adequate resilient. There is cushioning material underneath and around the inside and outside play areas. On the outside play area, there is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed.

LPA observed staff providing care and supervision children. The Staff monitors food intake and/or special diets; provides toileting and dressing assistance (age appropriate) if needed, and assist in other personal hygiene needs; etc. At no time the LPA observed no child being unsupervised.

The LPA advise Facility Site Supervisor to continue to become very familiar with the Guardian Background Check Program and with the Regulatory Enforcement (CARE) Tools processes, to visit the Departments Website at www.ccl.ca.gov at least on a weekly basis to obtain the most current Child Care information. Per Director, the Facility Administrative file contains all documents and forms listed on LIC 311A, Records to be Maintain at the Facility(Child Care Centers, Infant Centers, School-Age Centers and Child Care Centers for Mildly Ill Children) which is required under sections of Title 22, California Code of Regulations and/or Statute, as applicable.

The Center does not provides Incidental Medical Services. Nonetheless, the LPA provided PIN 22-02-CCP (Best Practices Related to the provision of Incidental Medical Services.)

Regarding COVID-19, the LPA advised the Director that Licensees and providers should continue to follow COVID-19 requirements and guidance in all applicable CDSS Providers Information Notices (PINs) and All County Information Notices (ACINs), If there are differing requirements between the most current CDC, CDPH, CDSS, DDS, Cal/OSHA, and local health department guidance or health orders, licensees and providers should follow the strictest requirements.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

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: VICTOR VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 360908874
	VISIT DATE: 09/29/2022

NARRATIVE

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The LPA conducted a review of several Staff records. The review included, but was not limited to the following: Criminal record statements (LIC 508) Record of submission of Child Abuse Index Checks. Staff qualification. Reference letters and verifying work experience on file. Health clearances, including TB clearances. Pediatric CPR/first aid cards for designated staff. 15 hours of health & safety training for designated Staff. Notice of Employee Rights receipts (LIC 9052). Statement Acknowledging Requirement to Report Suspected Child Abuse. (LIC 9108) and Mandated Reporter Training certificate. Copy of driver’s license. Personnel Record (LIC 501) or application/resume with required information.

A review of staff records on today's date indicates that the Center staff and other individuals listed on the LIC 500, Personnel Report and other personnel working at the Facility have received Criminal Record, FBI, DOJ. and Child Abuse Central Index Check clearances or exemptions.

Also, a review of several Children records was conducted. The review included, but was not limited to the following: Admission agreements. Immunization Records (“blue cards; PM 286) for non-school-age children. Authorizations for dispensing medications signed by parents. Identification and Emergency Information forms (LIC 700) Child’s Pre-admission Health History- Parents’ Report forms (LIC 702) Child’s Pre-admission Health Evaluations- Physician’s Report forms (LIC 701) Documentation required for health-related services (e.g., blood-glucose monitoring, nebulizer care LIC 9166, gastrostomy-tube care LIC 701A and LIC 701B) Consent for Emergency Medical Treatment forms (LIC 627) Unusual Incident/Injury or Death Reports (LIC 624) Parents’ Rights (LIC 995) receipts, signed and dated. Personal Rights receipts (LIC 613), signed and dated.

At the time of the inspection, the LPA observed appropriate Staffing Ratio and Capacity: Staffing ratios per number of children in care was in compliance.

Per Center Supervisor and Staff interviewed all children in care are accorded with their Personal Rights. Each child in the facility receiving services is treated with dignity and respect and have certain rights that will never be waived or abridged by anyone providing services in the facility regardless of consent or authorization from the child's authorized representative.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

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: VICTOR VALLEY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 360908874
	VISIT DATE: 09/29/2022

NARRATIVE

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The Center Director and staff are aware of Title 22 Reporting Requirements in accordance with Title 22 (101212) The facility uses LIC 624 (Unusual Incident/Injury Report form)

The LPA advise the Facility Supervisor to become familiar with the Guardian Background Check Program and Title 22, California Code of Regulations. The LPA provided information regarding where to locate Information Provider Notices (PINs) Training (e.g. Mandated Reporter) and how to access and subscribe to Child Care Licensing Quarterly Updates.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care. Therefore, no deficiencies were cited.

Overall, the Center is in compliance per Title 22 regulations, no deficiencies cited during this inspection.

An exit Interview was conducted and a copy of this Report, Children's Record Review form, LIC 857, Review of Staff Records form, LIC 859, Notice of Site Visit, LIC 9213 were provided to Ms. Santiago.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC809 (FAS) - (06/04)

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