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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364807230
Report Date: 03/02/2022
Date Signed: 03/02/2022 02:43:15 PM


Document Has Been Signed on 03/02/2022 02:43 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: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: 14DATE:
03/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Teacher, Kimberly WilliamsTIME COMPLETED:
02:55 PM
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Licensing Program Analyst (LPA) Zirbes met with the site teacher Kimberly Williams for the purpose of conducting an unannounced required one-year inspection for the preschool. LPA toured and inspected the facility in accordance with the facility sketch. There were 10 preschool age children, one teacher, and two aides on the premises when LPA arrived. The preschool program is operated out of one modular classroom (PS 1). The classroom is located on the campus of Arrowhead Elementary school. The programs hours of operation are Monday thru Friday 8:00-4:00pm . The preschool program has two sessions each day, AM session 8:30 AM -11:30AM and PM session 12:30 P.M -3:30 P.M.
Indoor/Children's Area:
Child care center was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were inaccessible, no poisons on the premises, furniture/equipment is in good condition. Classroom was free of flies, other insects, rodents. The classroom had four tables and over 20 chairs to meet children’s needs. LPA observed the classroom had a dramatic play area, science area, library and additional areas for instruction. The classroom had diverse play equipment, along with multiple blocks, puzzles and age appropriate materials. Children's belongings are kept in cubbies along the wall as you enter classroom. Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors via a drinking fountain and water pitchers. All materials and surfaces are toxic free, window screens in good repair and free of debris. There is a working Carbon monoxide detector, smoke detector and two Fire Extinguishers, 5HISA40 ABC. There are three bathrooms within the classroom. One designated for the staff member and the other two bathrooms are utilized by the children. Each bathroom had one toilet and one hand washing sink, which were observed to be in safe and sanitary operating condition. Curtains and a door provide each individual with privacy. Toilets and sinks are functioning properly and are age appropriate. LPA observed soap, toilet paper and paper towels readily available. Report continued on page two
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2022
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 5


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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 03/02/2022
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Report continued from page one
Only cold water is provided in the child bathrooms. There was working telephone service on the premises. There is an isolation area for children who become ill. The isolation area is located at the nurses office within the front office of the school. The facility maintains a comfortable temperature at all times, first aid supplies (thermometer, bandages, scissors), sign in/out sheets were available and completed daily. Smoking is prohibited on the premises, daily inspection for illnesses conducted by the teacher each day. LPA did not observe prohibited childcare items during this inspection. Firearms/weapons are not allowed or stored on premises. LPA did not observe bodies of water on the premises. Breakfast is provided to the AM session and lunch is provided to the PM session. The meals are provided by the school cafeteria.

Napping
The preschool program only offers half day programs. Therefore, the children do not nap at the facility. The classroom does have designated areas for relaxation and quite play.
Outdoor
The preschool program utilizes Arrowhead Elementary School kindergarten outdoor play area. LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness . The area has one large Playworld play structure. The large play structure has six slides. The cushioning material under the play structure was rubber matting. The large play structure was securely anchored to the ground. LPA also observed tricycles, balls, chalk and four tables for the children to utilize. The area was observed to be free of debris at the time of this inspection. Drinking fountains are located within the play yard for the children. Umbrellas are set up for shade when required by the weather.

Health Related Services
A review of medication policy indicated that only prescription medication is administered and only with parent's written permission. Incidental Medical Services were discussed. At the time of this inspection, no medications are being administered. If medications are required, they are stored in a locked cabinet labeled with the child's name. Refrigerated medications are stored in the nurses offices.

Report continued on page three
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 03/02/2022
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Report continued from page two

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

Staff/Personnel Records


LPA reviewed 10 child record and three staff files during this inspection. Records were completed and contained the required documentation. Lead teacher was qualified, Designation of Responsibility observed, immunization, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file.

Facility Records


LPA and Facility representative reviewed the LIC 311A Records To Be Maintained At The Facility. LPA observed a current roster, disaster drill log, current CPR/First Aid with expiration date of 07/07/2023 and current mandated reporter training which expires 8/31/2023.

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 393L), menu, car seat law (PUB 269), emergency disaster plan, earthquake preparedness checklist.

Other: Electrical outlets are inaccessible, there are no recalled and or prohibited toys or sleep/play equipment observed on the premises. Window cords were inaccessible to children

Report continued on page four

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 03/02/2022
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Report continued from page three

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 family child care laws 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.

Facility representative was advised of the requirement to report Unusual Incidents. Facility representative informed to utilize the Unusual Incident Report/Injury Report LIC624 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 family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The On-Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.



Facility representative was reminded that all adults 18 and over, 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 Child Care Center. 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.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

Report continued on page five

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: SBCUSD-ARROWHEAD PRESCHOOL
FACILITY NUMBER: 364807230
VISIT DATE: 03/02/2022
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. 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

No deficiencies were observed during this inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Kimberly Williams.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5