364843306-6-21-2022-12-CC-SMOA-CFLPP6-20220621112902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364843306
Report Date: 06/21/2022
Date Signed: 06/21/2022 11:29:08 AM

Document Has Been Signed on 06/21/2022 11:29 AM - 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:	BONANZA SCHOOL, LLC		FACILITY NUMBER:	364843306
ADMINISTRATOR:	MELISSA WOJCIK		FACILITY TYPE:	830
ADDRESS:	14624 BONANZA ROAD		TELEPHONE:	(760) 241-7800
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	14	CENSUS: 3	DATE:	06/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:42 AM
MET WITH:	Lead Michella Evans		TIME COMPLETED:	11:28 AM

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 with Lead Teacher, Michella Evans for the purpose of an Random Annual inspection of the Bonanza CCC Infant center. LPA observed 1 children and 1 teachers present during inspection. Infant care center consists of 1 classrooms and kitchen area. Per LT, the CCC hours of operation: 6:00 am to 6:30 pm. During this inspection LPA toured the facility, observed equipment/supplies, and reviewed a sample of children and staff files. Current Pediatric CPR and First Aid was observed (Exp. 1/2023). LPA observed sign in and out sheets. LPA observed CCC furniture and equipment were inspected for age appropriateness and good repair. All rooms observed to be clean and safe. Telephone service was verified. 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 of water pitchers and disposable cups. LPA observed a sufficient quantity of cribs available for napping children. LPA observed 8 cribs which were empty with no items inside. Per LT, medications are stored in office. Facility has a surveillance system on the premises. LPA observed fire extinguisher, smoke detector and carbon monoxide detector which were operable. The following information was discussed with the licensee: ü Mandatory Forms for the children’s files and provider’s files. ü Requirements for fire drills, earthquake drills, and documentation for both. ü The role and responsibilities of being a mandated reporter were discussed. ü The licensee is reminded that 100% supervision is required for children at all times.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022

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: BONANZA SCHOOL, LLC	FACILITY NUMBER: 364843306
	VISIT DATE: 06/21/2022

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Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified. Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No Deficiencies cited:

Exit interview conducted and inspection report, appeal rights and notice of site visit was reviewed with the LT Michella Evans.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022

LIC809 (FAS) - (06/04)

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