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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364805430
Report Date: 10/29/2019
Date Signed: 10/29/2019 03:47:41 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:MT. CALVARY KIDS CORNERFACILITY NUMBER:
364805430
ADMINISTRATOR:VICKEY ENGLANDFACILITY TYPE:
850
ADDRESS:32054 HUNSAKER WAYTELEPHONE:
(909) 867-7228
CITY:RUNNING SPRINGSSTATE: CAZIP CODE:
92382
CAPACITY:49CENSUS: 8DATE:
10/29/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Vicky EnglandTIME COMPLETED:
02:00 PM
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Licensing Program Analyst Aaron Mabika met with Center Director, Vicky England today for the purpose of conducting an unannounced Annual/Random inspection for the Pre-School. There are 8 children present upon arrival with 3 teachers in 1 classrooms Per director, the hours of operation are 006:30 AM -06:30 Monday -Friday. The Center also has a School-age component.

LPA verified there of the 3 staff whose files were reviewed all had current CPR and First Aid training (exp. 01/2021
*Center provides Snack and parents bring lunch. Allergy lists were reviewed and posted. Food and snacks were reviewed for availability, quantity, proper storage, and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. (1 refrigerator, sink, stove/oven).
*Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored in kitchen locked cabinet.
* Bathrooms were toured and LPA noted all toilets (3), sinks (1) were sanitary and operational. LPA observed soap, paper towel and toilet paper and water tested at a safe temperature. In each classroom LPA observed a water fountain, cubbies with children's names identified and cots.
*All flooring was found to be clean and safe. .
**Teacher/child ratio observed, care and supervision were discussed, children's records were reviewed, parent board observed and fire drills are current. Fire extinguisher operable and had current service tags and smoke and carbon monoxide detectors were determined to meet the State Fire Marshal standards.
*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.
*First Aid supplies were inventoried, a review of medication policy, including administering, labeling, and storage.
*Telephone service, heating, lighting and ventilation were evaluated.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019
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 3
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: MT. CALVARY KIDS CORNER
FACILITY NUMBER: 364805430
VISIT DATE: 10/29/2019
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*Outdoor area was observed to have a physical separation of components and equipment were inspected for safety, cushioning material in the form of rubber chips, in good repair and age appropriateness, LPA noted shade, climbing equipment anchored to the ground, a sand pit and some age appropriate toys: There are no bodies of water on the premises.
*Isolation area is in the school office along within access of bathroom

ADMINISTRATION:
*Director is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.
*There were no excluded individuals present; staff present were fingerprint cleared and associated, LPA and Director reviewed Personnel Report (LIC 500) together during this inspection.
A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Director administers medication and documents the dosage, date and time onto a log. Medication brought and taken home by the parent daily. Medication is properly labeled and stored in its original container.
*Center was found to be operating within its specified ratio and capacity.
*Sign in and Out sheets were inspected.
A sampling of 5 children’s files was reviewed and contained emergency contact information and 3 staff files were reviewed and contained the required qualifications.

LPA discussed the following:
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include:
· Serious health and safety violations resulting in Type A citations;
· Non-compliance conferences; or
· Efforts by the Department to revoke a facility’s license. Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: MT. CALVARY KIDS CORNER
FACILITY NUMBER: 364805430
VISIT DATE: 10/29/2019
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Failure to meet the posting requirements shall result in an immediate civil penalty. In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.

This facility provides Incidental Medical Services – IMS only when necessary. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 Centers and ADA, available at: http://www.ada.gov/childqanda.htm
***Center has Physical separation for each component (101438.3)
Director is advised to visit www.shotsforschool.org for Immunization information.
Director was informed of responsibility to report suspected Child Abuse, 1-800-540-4000.
Director is advised for quarterly updates to contact the Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.
Facility is operating according to California Code of Regulations Title 22 and no deficiencies were cited today An advisory note was provided to address the following corrections;
1) The center needs a smoke detector installed in the kitchen since there is a stove that may be used for cooking.
2) All food stuffs opened should be labelled with the date it was opened.

Exit interview conducted with Director Vicky England. A copy of the Appeal Rights (LIC 9058) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.
A Confidential Names list (LIC 811) was provided during this inspection.
Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019
LIC809 (FAS) - (06/04)
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