364810042-4-5-2023-12-CC-DMAX-CQLQQ2-20230405122138

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364810042
Report Date: 04/05/2023
Date Signed: 04/05/2023 12:21:45 PM

Document Has Been Signed on 04/05/2023 12:21 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	SBCUSD-HILLSIDE PRESCHOOL		FACILITY NUMBER:	364810042
ADMINISTRATOR:	LATASHIA KELLY		FACILITY TYPE:	850
ADDRESS:	4975 MAYFIELD AVENUE		TELEPHONE:	(909) 730-3674
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92407
CAPACITY:	24	CENSUS: 23	DATE:	04/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Lead Teacher, Stephanie Robles		TIME COMPLETED:	12:36 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 Analyst (LPA) Maddox met with Lead Teacher, Stephanie Robles for the purpose of conducting an unannounced Required 1 yr inspection. This is a State PS Program conducted on the grounds of Hillside Elementary School in a modular. The programs hours of operation: Monday - Friday from, 8:20 am 11:20 am and 12:20 pm to 3:20 pm in Rm PS#16. Preschool classroom has a separate exit and entrance from the elementary school. LPA observed age appropriate furniture, equipment, toys and materials. The classroom was observed to be clean and safe and free of any Health or safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the wall as you enter classrooms. Drinking water is available inside the classroom in the form of a water fountain. Lead testing was conducted 1/24/23 was tested and were within limits. The children's bathrooms are located within the classroom (2). Each bathroom has 1 toilet and 1 sink. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate. Staff restroom is located in the main building. **Two half day programs, children do no not nap at this site. All flooring and carpets were inspected for cleanliness, and in good repair. Breakfast and Lunches are brought over daily from the school cafeteria.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SBCUSD-HILLSIDE PRESCHOOL	FACILITY NUMBER: 364810042
	VISIT DATE: 04/05/2023

NARRATIVE

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**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material. Large play equipment and climbing structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available in the form of a water fountain. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area.

**The Parent Board located within the classrooms has contains required licensing forms. Staff are certified in Pediatric CPR and First Aid (exp 4/25). Children files reviewed today were complete including current/required immunization's. Center utilizes electronic sign in and out sheets. LPA observed a fully stocked first aid kit; fully charged fire extinguishers; carbon monoxide detectors throughout the center. Fire Drill/Earthquake log is posted.

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 -

There were no violations noted as a result of this inspection, Center is operating in accordance to Title 22 Regulations. Exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

LIC809 (FAS) - (06/04)

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