364811626-2-26-2020-12-CC-JNEL-BM6PGJ-20200226101821

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364811626
Report Date: 10/10/2019
Date Signed: 02/26/2020 10:18:28 AM

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:	SBCSS-LIBERTY STATE PRESCHOOL		FACILITY NUMBER:	364811626
ADMINISTRATOR:	JANON STRICKLAND		FACILITY TYPE:	850
ADDRESS:	12900 AMETHYST ROAD		TELEPHONE:	(760) 951-8738
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	48	CENSUS: 38	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Janon Durham		TIME COMPLETED:	03:00 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) Neal met with the Site Supervisor, Janon Durham for the purpose of an Annual/Random inspection of the preschool. The facility operates half days from 7:30am to 10:30am and 11:15am to 2:15 pm and consists of 2 classrooms (Room #33 and Room #34) on the grounds of Liberty State Elementary. LPA observed 38 children total present (22 in Room #34, 16 in Room 33). There was 1 teacher, 1 associate teacher and 1 sub and 1 volunteer in Room 34 and 1 teacher, 1 associate teacher in Room #33. During this inspection, LPA 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 current (site supervisor's expires 7/2021). Furniture and equipment were inspected for age appropriateness and good repair. Rooms were observed to be clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. LPA observed age appropriate toys and materials. The preschool shares the outdoor play space and the shared bathroom with primary school students (alternates times, no co-mingling). Bathroom is to the left of classrooms and 5 toilet stalls and 2 sinks in the girl's bathroom and the boy's bathroom has 2 toilet stalls, 2 urinals, 2 sinks and is also used. There is soap, toilet paper and paper towels readily available. Staff bathroom is separate located between the 2 children's bathrooms. Emergency backpacks are close to the entrance of the classrooms. Fire extinguisher, carbon monoxide detector and smoke detector are all maintained by the elementary school. Sign in/out sheets are located beside the entrances. There are cubbies for children's belongings. Covered trash bins observed. Medications are stored in a locked cabinet, made inaccessible in a lock box.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SBCSS-LIBERTY STATE PRESCHOOL	FACILITY NUMBER: 364811626
	VISIT DATE: 10/10/2019

NARRATIVE

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Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. The area was observed to be free of debris. Play yard is through a gate in front of the classrooms. Staff store play equipment and toys for the preschool in sheds on the playground. LPA observed toys to be age appropriate and in good repair. There is grass and concrete areas for active play as well as swings and a large anchored climbing structure with wood chips underneath. There are no bodies of water on the premises. Water fountains are operable for drinking in the play area.

The facility provides breakfast for the am class and lunch for the p.m. class. Menus were observed posted. There is a cot available for ill children and space available by the teacher's desk. Per staff, there are currently no children who require Incidental Medical Services (IMS). In the event that medications are administered, it is by the staff and a log is kept with parent/guardian's written permission.

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.

Lead teacher was reminded to access the Licensing website at ccld.ca.gov to obtain information about the most recent regulatory changes and the Quarterly Updates.

Mandated Reporter training must be taken every 2 years for all staff and volunteers. Mandated Reporter certificates reviewed are current.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SBCSS-LIBERTY STATE PRESCHOOL	FACILITY NUMBER: 364811626
	VISIT DATE: 10/10/2019

NARRATIVE

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Staff was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624.

LIC 9213- Notice of Site Visit was given to be posted for 30 days.
No deficiencies were cited during this inspection.

Exit interview was conducted, report was read and a copy was provided to the lead teacher.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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