364811626-8-29-2022-12-CC-SMOA-CHRTRX-20220829145816

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364811626
Report Date: 08/29/2022
Date Signed: 08/29/2022 02:58:57 PM

Document Has Been Signed on 08/29/2022 02:58 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:	SBCSS-LIBERTY STATE PRESCHOOL		FACILITY NUMBER:	364811626
ADMINISTRATOR:	NANCY ALVARADO		FACILITY TYPE:	850
ADDRESS:	12900 AMETHYST ROAD		TELEPHONE:	(760) 951-8738
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	48	CENSUS: 12	DATE:	08/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Ron Osborn Head Teacher		TIME COMPLETED:	03:10 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) Steven Montoya met Lead Teacher, Ronald Osburn for the purpose of an Annual/Random inspection of the Child Care Center. The preschool consists of 2 classrooms (room # 33 and 34). Teacher/child ratios were observed which meets title 22 regulations. LPA observed 12 children (#34) and 16 children (#33) 5 teachers present during the time of the inspection. Facility hours of operates 7:45 am to 2:45 pm (2 shifts AM and PM). During this inspection LPA toured two classrooms, observed equipment/supplies, and reviewed a sample of children (5) and staff (3) files. LPA observed :Furniture and equipment were inspected for age appropriateness and good repair. All rooms observed to be clean and safe. Telephone service was verified (760 243 1198). Heating, lighting, and ventilation are adequate. There are cubbies with children's names on them for their belongings in each classroom. LPA observed age appropriate toys and materials. Drinking water is available inside the classrooms in the form push button fountain. Per LT, children do not sleep at site. Medications are stored in a lockbox in the refrigerator. Facility has a surveillance system on the premises. Fire extinguisher, smoke detector and carbon monoxide detector were observed to be operable condition. LPA observed Lead Teachers Pediatric CPR and First Aid was observed (Exp. 8/2023).

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022

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: SBCSS-LIBERTY STATE PRESCHOOL	FACILITY NUMBER: 364811626
	VISIT DATE: 08/29/2022

NARRATIVE

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LPA inspected and observed the 3 bathrooms to be clean, functioning properly and age appropriate. LPA observed them all to be clean with soap, toilet paper and paper towels readily available in each.

Outdoors: Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. LPA observed small and large (anchored) play structures with sand underneath and a grass area for active play. There is also a concrete path for tricycles. The area was observed to be free of debris. There is an area for shade and rest.

Fire/earthquake drills are current. Staff was reminded to review the Licensing website at ccld.ca.gov to obtain information about the most recent regulatory changes and the Quarterly Updates.

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

No deficiencies cited.

Exit interview conducted and provided inspection report, appeal rights and Notice of Site Visit was given to be posted for 30 days to Lead Teacher.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022

LIC809 (FAS) - (06/04)

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