364840539-10-28-2019-12-CC-SMOA-BHDUXE-20191028155812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364840539
Report Date: 10/28/2019
Date Signed: 10/28/2019 03:58:21 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	LILLY BUG'S CHILDREN CENTER		FACILITY NUMBER:	364840539
ADMINISTRATOR:	LANGDO, TERESA		FACILITY TYPE:	840
ADDRESS:	4280 LINDERO STREET		TELEPHONE:	(760) 868-6344
CITY:	PHELAN	STATE: CA	ZIP CODE:	92371
CAPACITY:	14	CENSUS: 4	DATE:	10/28/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:51 PM
MET WITH:	Director Erica Romero		TIME COMPLETED:	04:12 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) Montoya met with Child Care Facility (CCF) Director Erica Romero, today for the purpose of conducting an unannounced Annual/Random inspection for the child care facility. CCF has an School-age component. There were 4 children present, with 2 teachers providing care. Hours of operation are: *Monday thru Friday (between 6:00 am – 6:00 pm).* Note: Since facility has several components of Child Care (Infant, Pre school and School age)CCF requested to commingle pre-school with school age children before and after school, and on school breaks. On 07-24-2019, Center is requesting an Waiver. DOCUMENTATION INSPECTION: With director present, LPA reviewed records to verified accuracy: 1. Sampling of children's records (See LIC 857) 2. Sign In and Out sheets were inspected. 3. Emergency contact information observed 4. Parent board observed 5. Staff personnel files reviewed for educational and certification. (See LIC 859 & LIC 500) 6. Pediatric CPR and First Aid training for one staff (EXPIRES: 03-23-2021) 7. Mandated Reporter Training (EXPIRES: 09-06-2020) 8. Emergency Fire Drills were current and up to date

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 789-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019

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: LILLY BUG'S CHILDREN CENTER	FACILITY NUMBER: 364840539
	VISIT DATE: 10/28/2019

NARRATIVE

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INDOOR INSPECTION:
During today’s inspection, LPA toured the location. Observed teacher/child ratio, care and supervision. **Fire Extinguisher up to date and operable. (Completed: 06-15-2019 )
Bathrooms (2) were inspected and LPAs noted all toilets (2), sinks (2) were sanitary and operational. LPAs observed soap, paper towel and toilet paper. Tested water at a safe temperature. Each classroom has a water fountain, cubbies with children's names identified. All flooring was found to be clean and safe
**(Director states carpets are cleaned every 4 month. Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored in kitchen locked cabinet. Trash cans/storage containers for solid waste were covered with tight-fitting tops that are kept on, and in good repair. *Snack/lunch menu’s, Allergy list were reviewed and posted. Food and snacks were reviewed for availability, quantity, proper storage, and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment. (2 refrigerator, 3 sink, stove/oven). Location had telephone service, heating/cooling, lighting and ventilation were evaluated. *First Aid supplies were discussed and inspected along with medication policy, including labeling, administering and appropriate storage in original container. A review of medication policy indicated prescription medications are administered with “parent's written permission”. Certified staff administers medications and documents: date, time and dosage onto a log. Medication brought and taken home by the parent daily.
*Incidental Medical Services (IMS) were discussed and location do not provide services.
*Children isolation area is located in the front office, along with the isolation bathroom.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 789-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019

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: LILLY BUG'S CHILDREN CENTER	FACILITY NUMBER: 364840539
	VISIT DATE: 10/28/2019

NARRATIVE

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OUTDOOR INSPECTION
*Outdoor area and equipment inspected for safety, cushioning material, good repair and age appropriateness, LPAs noted shade, and drinking water: No pool or bodies of water observed on the premises.

The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited: NONE

Exit interview conducted with Licensee XXXXXXX. A copy of the Appeal Rights (LIC 9058) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 789-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019

LIC809 (FAS) - (06/04)

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