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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843943
Report Date: 07/15/2021
Date Signed: 07/15/2021 03:26:20 PM

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:ROSITA R. SMITH H.Q. PRESCHOOL, INC.FACILITY NUMBER:
364843943
ADMINISTRATOR:ROSITA R. SMITHFACILITY TYPE:
830
ADDRESS:1455 E. LYNWOOD DRIVETELEPHONE:
(909) 804-8808
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:18CENSUS: 3DATE:
07/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:51 PM
MET WITH:Armanda HernandezTIME COMPLETED:
03:30 PM
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Licensing Program Analyst Aaron Mabika met with Executive Administrator, Armanda Hernandez, today for the purpose of conducting an unannounced Annual/Random Inspection for the Pre-School. There were 3 children present upon arrival under the care of 1 teacher in the Room 5 Infants classroom. Per licensee the hours of operation are 06.30 AM -05.00 PM, Monday -Friday. The Center also has an Preschool component. This facility does not provides Incidental Medical Services (IMS).
LPA verified that the director's records sampled have current CPR and First Aid training and additionally the Director's CPR 1st Aid/CPR expires on 01/3/2022.
The center was observed to be in full compliance of the CDC recommended physical distance, masking, symptom checks and logging. The Infants room was partitioned off with plexiglass enclosure housing 4 baby cots. The napping infants were observed to be properly distance, without masks and the Log ins were reviewed for completeness. An Infant Daily Changing report was on hand on a clip board.
*Snack and lunches are provided and current menus are displayed in the food preparation area and Formula Declination Forms were reviewed in the files. Per Administrative assistant, currently there is no child with allergies but the Allergy policy was discussed. 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. (LPA observed 1 refrigerator, sink, micro wave oven).
*Disinfectants, cleaning solutions, and other items that are dangerous or hazardous were inaccessible to children and stored in the high shelf in the off limits kitchen area.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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 5
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: ROSITA R. SMITH H.Q. PRESCHOOL, INC.
FACILITY NUMBER: 364843943
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2021
Section Cited

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101428 Infant Care Personal Services
(B) The floor space used for diaper changing, if soiled, shall be disinfected after each use


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Licensee failed to ensure this requirement was met by disinfecting the changing space after each use.
This poses a potential danger to children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:
DATE: 07/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: ROSITA R. SMITH H.Q. PRESCHOOL, INC.
FACILITY NUMBER: 364843943
VISIT DATE: 07/15/2021
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LPA observed one changing table with the right materials and staff observed that underneath the mat there were gold colored stains. Staff claimed they lay the babies on freshly rolled paper napkins and not direct on the mat. By the time the LPA left the changing table had been cleaned.
* The Classroom was observed to, on the whole sanitary. Water tested at a safe temperature. Lots of napping mats were observed stored neatly in a storage closet in the classroom. LPA observed that the children were napping on clean mats and well distanced from each other.
*All flooring was found to be clean and safe. Director states carpets are cleaned daily.
**Teacher/child ratio observed and 2 staff were on hand for relief., care and supervision was discussed, children's records were reviewed, parent board observed and fire drills are current (conducted monthly). LPA supplied center with a summary sheet for public display. The Fire extinguisher was operable and recently serviced. The center has a central fire alarm system too..
*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.

First Aid supplies were inventoried (in every classroom by the door), a review of medication policy, including administering, labeling, and storage. *Telephone service, heating, lighting and ventilation were evaluated.


*Outdoor area and equipment was inspected for safety, cushioning material, good repair and age appropriateness, LPA noted a foam rubber cushion around the play area shade provided by a wide patio cover, There are no bodies of water on the premises. LPA observed age appropriate play equipment.
*Isolation area is located in the front office along with a separate bathroom accessible to the office.
ADMINISTRATION:
*Director is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.*
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: ROSITA R. SMITH H.Q. PRESCHOOL, INC.
FACILITY NUMBER: 364843943
VISIT DATE: 07/15/2021
NARRATIVE
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There were no excluded individuals present; staff present were fingerprint cleared and associated, LPA and Director reviewed Personnel Report (LIC 500) together during this inspection.
A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Director administers medication and documents the dosage, date and time onto a log. Medication brought and taken home by the parent daily. Medication is properly labeled and stored in its original container.
*Center was found to be operating within its specified ratio and capacity.
*Sign in and Out sheets were inspected.
A sampling of children’s files was reviewed and contained emergency contact information, staff files were reviewed and contained qualifications.
LPA discussed the following:
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include:
· Serious health and safety violations resulting in Type A citations;
· Non-compliance conferences; or
· Efforts by the Department to revoke a facility’s license. Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection).

Failure to meet the posting requirements shall result in an immediate civil penalty.


In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: ROSITA R. SMITH H.Q. PRESCHOOL, INC.
FACILITY NUMBER: 364843943
VISIT DATE: 07/15/2021
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This facility does not provide Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 Centers and ADA, available at: http://www.ada.gov/childqanda.htm
***Center has Physical separation for each component (101438.3) and a playground waiver that is on file.
Licensee is advised to visit www.shotsforschool.org for Immunization information.
Licensee was informed of responsibility to report suspected Child Abuse, 1-800-540-4000.
Licensee is advised for quarterly updates to contact the Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.
Facility was cited a "B" type deficiency for the Changing table in accordance to California Code of Regulations Title 22. See LIC 809 D.
Exit interview conducted with Executive Administrator, Armanda Hernandez. Licensee’s signature on this form acknowledges receipt of these rights.
A Confidential Names list (LIC 857) was provided during this inspection.
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 YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
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