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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364801923
Report Date: 09/13/2023
Date Signed: 09/13/2023 01:27:11 PM


Document Has Been Signed on 09/13/2023 01:27 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:SBCSS SIEGRIST STATE PRESCHOOLFACILITY NUMBER:
364801923
ADMINISTRATOR:NANCY ALVARADOFACILITY TYPE:
850
ADDRESS:15922 WILLOW STREETTELEPHONE:
(760) 244-6225
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:63CENSUS: 18DATE:
09/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ernestine Steppes and Rosie DunnTIME COMPLETED:
01:51 PM
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Licensing Program Analyst (LPA) Babatunde Ibitoye met with Lead Teacher, Ms. Ernestine Steppes and Rosie Dunn today for the purpose of conducting an Required 1 year Annual inspection. This State Preschool occupies 2 classrooms (portable A, Siegrist II & Siegriest I-Portable C ) on the grounds of SIEGRIST Elementary School. The Preschool is fenced off and separated from Elementary school children. The facility operates Siegrist I AM Class 7:45am-10:45am and PM Class 11:30am-2:30pm, Siegrist II AM Class 8:15am-11:15am and PM 12:00 pm-3:00pm. Portable A, Siegrist II nhad 22C/3T & Siegriest I-Portable C bhad 20C/4T.

LPA observed age appropriate toys, materials, furniture and equipment; Both classrooms were clean and free of any Health of Safety hazards. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies in place for children's belongings. Water cooler with disposable cups are readily available for children.

LPA inspected and observed bathrooms inside each classroom (each bathroom contained 1 toilet and 1 sink), Children are escorted to additional bathrooms available in the main building. Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available.

Snacks is supplied by Rene Hope foundation. The facility has a clean and fully stocked refrigerator/freezer and the Teacher will pick up the food and bring to each classroom. Menus are posted in each classroom.

Sign in and out sheets were reviewed. LPA observed Licensing and Parent boards to be incompliance including the required posting (menu, daily schedule, community activities).First Aid Kit observed.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2023
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: SBCSS SIEGRIST STATE PRESCHOOL
FACILITY NUMBER: 364801923
VISIT DATE: 09/13/2023
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Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is not administered. There is a separate area for isolation and care of ill children in the office area.
Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Fire/earthquake drills is not current. See LIC 9102 (Advisory note) Roster current. There are fire extinguishers, smoke detectors, and carbon monoxide detectors in each classroom. All flooring and carpets were inspected for cleanliness, and in good repair.

Staff file review reveals staff are qualified for their perspective positions. Children's files contain required forms and documents. Additional forms and a copy of Title 22 Regulations may be obtained at the department's website www.ccld.ca.gov.

*Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes sand and hard rubber mats under climbing structure; there is sufficient and adequate shade available. Large play equipment and climbing structures are securely anchored (swing set and 1large climbing structures). The area was observed to be free of debris. Outside Drinking water is available in the form of drinking fountain. Sandboxes are raked and inspected daily and kept free of hazardous foreign materials. There are no bodies of water observed on the premises. The entire playground is enclosed to protect children and to keep them in the outdoor activity area.

The following general information was discussed during this inspection:



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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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: SBCSS SIEGRIST STATE PRESCHOOL
FACILITY NUMBER: 364801923
VISIT DATE: 09/13/2023
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· On January 1, 2018, or before March 30, 2018, a person who is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatedreporterca.com

Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care 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 on-line 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.

Fingerprint clearances and transfers: 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 of a criminal record clearance from one state licensed facility to another using form LIC 9182

Lead Teacher advised of the requirement to report Unusual Incidents. Licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of the daycare center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8 am-5 pm.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The director shall permit the Department to inspect the family child care home and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: SBCSS SIEGRIST STATE PRESCHOOL
FACILITY NUMBER: 364801923
VISIT DATE: 09/13/2023
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A survey will be sent to the email address provided to improve the quality and value of the new inspection process. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiency was cited today. LPA Issued 2 Technical Advisory Note

An exit interview was conducted and the report was reviewed with the Lead Teacher Ernestine Steppes

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6