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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364807230
Report Date: 01/22/2020
Date Signed: 01/22/2020 03:47:56 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:SBCUSD-ARROWHEAD PRESCHOOLFACILITY NUMBER:
364807230
ADMINISTRATOR:DELIA CASTANEDAFACILITY TYPE:
850
ADDRESS:3825 MOUNTAIN VIEW AVENUETELEPHONE:
(909) 881-8100
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY:24CENSUS: DATE:
01/22/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:58 PM
MET WITH:Kimberly WilliamsTIME COMPLETED:
04:03 PM
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Licensing Program Analyst Aaron Mabika met with Site Supervisor, Kimberly Williams today for the purpose of conducting an unannounced Annual/Random inspection for the Pre-School. There 13 children (ages 3-5) present upon arrival with 1 teacher and 2 Instructional Aides. Per Supervisor, the hours of operation are 08:00 AM -04:00 PM Monday -Friday broken into 2 sessions namely the AM and PM sessions.
LPA verified the site supervisor present has current CPR and First Aid training (exp. 05/04/2019)
* One meal per session (Breakfast/Lunch) is provided. Allergy lists and menus were reviewed and posted.
*Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were observed to be inaccessible to children and stored in locked cabinet by the Teacher's desk.
* Bathrooms (2) were toured and LPA noted all toilets (2), sinks (3) were sanitary and operational. LPA observed soap, paper towel and toilet paper and water tested at a safe temperature. The classroom was observed to have a water fountain, cubbies with children's names identified.
*All flooring was found to be clean and safe (Director states carpets are cleaned every month.
**Teacher/child ratio observed, care and supervision were discussed, 5 children's records and 3 staff records were reviewed, parent board observed and fire drills are current. Staff was advised to transfer the Disaster Drill Records onto an official sheet. Fire extinguisher operable with a service date of June 17, 2019. LPA counted at least 4 carbon Monoxide and one CO2 detector
*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.
*First Aid supplies and Emergency Disaster supplies were inventoried. Per Supervisor, Isolation area is in the front office along with the isolation bathroom room complete with a sick bed and a nurse.
*Telephone service, heating, lighting and ventilation were evaluated.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 01/22/2020
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*Outdoor area and equipment were inspected for safety, cushioning material, good repair and age appropriateness. LPA observed a climbing structure/slide set, set in foam rubber , a bike trail, game area, water fountain and 8 foot perimeter fence. LPA noted shade in the form of 2 large umbrellas, park bench sets. No bodies of water were observed.
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 children’s files was reviewed and contained emergency contact information, staff files were reviewed and contained 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) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 01/22/2020
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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. 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
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 was cited any deficiency(ies) as they , at this time were deemed to be operating according to California Code of Regulations Title 22. Exit interview conducted with Site Supervisor Kimberly Williams. A 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) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
LIC809 (FAS) - (06/04)
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