364841490-4-5-2022-12-CC-DMAX-CD7QEC-20220405120607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364841490
Report Date: 03/28/2022
Date Signed: 04/05/2022 12:06:12 PM

Document Has Been Signed on 04/05/2022 12:06 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:	FUNDAMENTALS ACADEMY INFANT PROGRAM, THE		FACILITY NUMBER:	364841490
ADMINISTRATOR:	EVELYN CHINCHILLA		FACILITY TYPE:	830
ADDRESS:	2424 KENDALL DRIVE		TELEPHONE:	(909) 887-1150
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92407
CAPACITY:	7	CENSUS: 0	DATE:	03/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Evelyn Chilchilla		TIME COMPLETED:	12:30 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) Maddox met with Director, Evelyn Chinchilla 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. 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. 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. 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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

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: FUNDAMENTALS ACADEMY INFANT PROGRAM, THE	FACILITY NUMBER: 364841490
	VISIT DATE: 03/28/2022

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**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

There were no Infants present during this inspection, Director, Ms. Evelyn states they have put the Infant component on hold temporarily as a result of the COVID - 19 pandemic. LPA took the opportunity to inform staff of the updated safe sleep regulations including checking on and documenting every 15 min and form LIC 9227.

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 Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

LIC809 (FAS) - (06/04)

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