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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841490
Report Date: 08/23/2019
Date Signed: 08/23/2019 03:34:10 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:FUNDAMENTALS ACADEMY INFANT PROGRAM, THEFACILITY NUMBER:
364841490
ADMINISTRATOR:EVELYN CHINCHILLAFACILITY TYPE:
830
ADDRESS:2424 KENDALL DRIVETELEPHONE:
(909) 887-1150
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:7CENSUS: 5DATE:
08/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:26 PM
MET WITH:Evelyn ChinchillaTIME COMPLETED:
03:40 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Evelyn Chinchilla and Asst. Director, Virgina Robles today for the purpose of conducting and unannounced Annual/Random inspection. This center is also licensed for an Preschool Component (X364817412) and School-Age component (X 364840755). Each component maintains a physical separation indoors and outdoors. Hours of operation: MON - FRI 7:00AM- 6:00 PM. LPA reviewed a sampling of staff and children files as part of this inspection (Names recorded on LIC 811 and LIC 859 dated 8/23/19).

**The Infant component is operated in a separate detached building in the rear of facility. LPA observed age appropriate furniture, equipment, toys and materials. There is a physical barrier from the cribs and general area. The room 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. LPA observed children's bottles and drinking cups labeled with each infants name.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
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: FUNDAMENTALS ACADEMY INFANT PROGRAM, THE
FACILITY NUMBER: 364841490
VISIT DATE: 08/23/2019
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**There is a diaper changing table within arms reach of a sink. The staff rest-room is located in the main building entrance area, the staff bathroom is also used as an isolation bathroom.

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. There were no safety hazard observed. 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. .

**Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Center serves breakfast and lunch, 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



**LPA informed Director 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

**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations.
A sampling of Children's and Staff records were reviewed as part of this inspection. Staff are certified in Pediatric CPR and First Aid (exp 9/15/2020).
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
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: FUNDAMENTALS ACADEMY INFANT PROGRAM, THE
FACILITY NUMBER: 364841490
VISIT DATE: 08/23/2019
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**The Parent Board located within the classrooms has contains required licensing forms.

Sign in and out sheets were inspected and contain full legal signatures. 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 - None at this time

§1596.8662 On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. - Missing

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
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: FUNDAMENTALS ACADEMY INFANT PROGRAM, THE
FACILITY NUMBER: 364841490
VISIT DATE: 08/23/2019
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§1596.7995 -(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

LPA verified fingerprint clearances for staff present.



Copy of 811 (Confidential Names List) was provided during this inspection. 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: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4