364808389-2-20-2020-12-CC-JNEL-BLYVXA-20200220154912

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364808389
Report Date: 02/20/2020
Date Signed: 02/20/2020 03:49:21 PM

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:	CHAMPIONS/EAGLE RANCH		FACILITY NUMBER:	364808389
ADMINISTRATOR:	CYNTHIA CUMMINGS		FACILITY TYPE:	840
ADDRESS:	12545 EAGLE RANCH PARKWAY		TELEPHONE:	(760) 948-6820
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	56	CENSUS: 6	DATE:	02/20/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Jodie Kester		TIME COMPLETED:	04:05 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	Licensing Program Analysts (LPAs) Neal and Flores met with the site director, Jodie Kester for the purpose of an Annual/Random inspection of the School Age center. LPAs observed 6 children, 1 teacher and the Site Director upon arrival. The facility consists of 2 classrooms (Room 1 and Room 2). The facility is a before/after school program that operates from 6:00 am to 8:30 am and 1:00pm to 6:30 pm. During this inspection, LPAs toured the facility, observed equipment/supplies, and reviewed a sample of children and staff files. Incidental Medical Services (IMS) were discussed. Current Pediatric CPR and First Aid was observed. Furniture and equipment were inspected for age appropriateness and good repair. All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings in each classroom. LPAs observed age appropriate toys and materials. Drinking water is available inside the classrooms in the form of a water dispenser and disposable cups. Medications are stored in the kitchen on top of the refrigerator in a lock box. Fire extinguishers were observed to be in operable condition. Facility contains a smoke detector/carbon monoxide detector dual alarms connected through the elementary school. Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. Children play on the elementary school's playground. LPAs observed a large, securely anchored play structure with padded ground for cushioning (currently under repair), basketball hoops and swings (sand underneath). There is shade and benches for rest and water fountains. The area was free of debris. There are no bodies of water on the premises.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

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: CHAMPIONS/EAGLE RANCH	FACILITY NUMBER: 364808389
	VISIT DATE: 02/20/2020

NARRATIVE

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Children are inspected for illnesses as they arrive. There is a mat available for ill children. A review of medication policy indicated that prescription medication is administered and only with parent's written permission. The site director or teacher administers medication and documents the dosage, date and time onto a log. Medication is retained in a lock box properly labeled and stored in its original container.

LPAs inspected and observed 2 clean bathrooms (1 in each room) with a sink and toilet. Functioning properly and age appropriate. Staff use the separate restroom located in Room 1. LPAs observed soap, toilet paper and paper towels readily available.

There is a clean, fully equipped kitchen with refrigerator/freezer, stove and sink. The facility provides am and pm snacks. LPAs observed monthly menu and allergy lists posted in the kitchen. LPAs observed an appropriate amount of food and snacks. The chemicals are kept separate from the food, under the sink by key lock.

Teacher/child ratios were observed. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Fire/earthquake drills are current. Roster observed current. Site Director was reminded to access the Licensing website at ccld.ca.gov to obtain information about the most recent regulatory changes and the Quarterly Updates.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

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: CHAMPIONS/EAGLE RANCH	FACILITY NUMBER: 364808389
	VISIT DATE: 02/20/2020

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Facility has an IMS action plan detailing who is trained to administer medication (Site Director and teacher) and physician's instructions. 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 Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Notice of Site Visit was given to be posted for 30 days. No deficiencies were cited during this inspection.

Exit Interview conducted, report was read and a copy was provided to Site Director.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

LIC809 (FAS) - (06/04)

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