364818072-5-2-2019-12-CC-TLAN-BBST2H-20190502142047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364818072
Report Date: 05/02/2019
Date Signed: 05/02/2019 02:23:50 PM

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:	BAKER VALLEY UNIFIED SCHOOL DISTRICT		FACILITY NUMBER:	364818072
ADMINISTRATOR:	TREMBLAY, RONDA		FACILITY TYPE:	850
ADDRESS:	72100 SCHOOL HOUSE LANE		TELEPHONE:	(760) 733-4567
CITY:	BAKER	STATE: CA	ZIP CODE:	92309
CAPACITY:	40	CENSUS: 7	DATE:	05/02/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:26 AM
MET WITH:	Monserrat Bernal		TIME COMPLETED:	02:38 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 (LPAs) Lawson and Maddox met with facility representative, Lead Teacher Monserrat Bernal, today today for the purpose of conducting and unannounced Annual/Random Inspection. Present today were 7 children and 2 staff. Ms. Bernal led LPAs on a tour of this State Pre-school which operates out of 1 large modular which is divided into two sections, one side is the classroom and the other side is used as the lunch room. This State Pre-School is located on the grounds of the Baker Unified School District which also has a Elementary School, Jr. High, and High School. Each different grade school maintains a physical separation. The Pre-School operates Monday- Friday and has two session (8:30AM-11:30AM and 12:30PM-3:30pm). Staff are fingerprinted through Baker School District. **LPAs observed age appropriate furniture, equipment, toys and materials. The classrooms were 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 located between the classroom and lunch room; drinking water is available inside the classroom in the form of a water cooler and disposable cups. Children also have labeled water bottles.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019

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 4

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: BAKER VALLEY UNIFIED SCHOOL DISTRICT	FACILITY NUMBER: 364818072
	VISIT DATE: 05/02/2019

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
26
27
28
29
30
31
32

**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations. Sign in and out sheets were inspected and contain full legal signatures. LPAs observed a fully stocked first aid kit; fully charged fire extinguishers; carbon monoxide detectors throughout the center. Fire Drill/Earthquake log is posted.

**Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Center serves breakfast and snacks only, menus observed and posted. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children.

**LPAs informed Ms. Bernal of the Departments Child Care Advocate’s (CCA’s) that can forward Quarterly updates regarding Child Care Licensing’s’ Rules and Regulations and offer personalized assistance. You may contact Jane Cong-Huyen, Child Care Advocate directly at (714) 308-1612. Email address: Jane.Cong-Huyen@dss.ca.gov

Ms. Bernal was advised to visit our website, www.ccld.ca.gov to review Quarterly updates/regulations for 2015-2019 on the department website: Summer 2015 - Incidental Medical Services information.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: BAKER VALLEY UNIFIED SCHOOL DISTRICT	FACILITY NUMBER: 364818072
	VISIT DATE: 05/02/2019

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
26
27
28
29
30
31
32

**There are 2 children's bathroom located on the lunch room side, each bathroom has 1 toilet and 2 sinks. LPAs 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 bathroom is located in adjacent building.

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes pea gravel under climbing structures for cushioning material. Large play equipment/climbing structure is securely anchored, play equipment is metal and plastic. 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 play yard has chain link fencing in place and at least 5 feet high. Children only play within the gated area. With regards to shade, LPAs observed minimal shade available, Lead Teacher Bernal stated that there was a shade structure in place; however, the tarp was destroyed during the wind storms. Tarps are expected to be replaced. LPAs observed the shade structure that the tarp will attach to when received. Building provides over hanging shade.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: BAKER VALLEY UNIFIED SCHOOL DISTRICT	FACILITY NUMBER: 364818072
	VISIT DATE: 05/02/2019

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
26
27
28
29
30
31
32

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

Ms. Bernal was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame (call within 24 hours and submit form within 7 days) specified by the regulation and on the form LIC624B.

Ms. Bernal was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

Staff and Children files were reviewed during this inspection and were found to be complete.

No deficiency. Consultation was provided during this inspection and an exit interview was conducted and a copy of this report was read to Ms. Bernal on this date.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Tyicee Lawson	TELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4