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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750026
Report Date: 05/20/2022
Date Signed: 05/20/2022 04:50:27 PM

Document Has Been Signed on 05/20/2022 04:50 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:LITTLE MOUNTAIN PRESCHOOLFACILITY NUMBER:
367750026
ADMINISTRATOR:DOGERO, APRIL MARIEFACILITY TYPE:
840
ADDRESS:2915 LITTLE MOUNTAIN DRTELEPHONE:
(909) 882-1100
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Administrator April Dogero TIME COMPLETED:
03:00 PM
NARRATIVE
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On May 20, 2022 at 9:20am Licensing Program Analyst (LPA) Zirbes met with the Administrator April Dogero. The purpose of the inspection was to conduct an unannounced required one year inspection. During the inspection, LPA toured and inspected the school age program in accordance with the facility sketch. At the time of this inspection there were zero school age children at the facility. The school age area consists of two adjacent classrooms (6, 11), one bathroom, and a outdoor space. The center also operates a Infant Center (#367750024) and Preschool Program (#367750025). The center operates 6:30am-6:00pm, Monday through Friday.

Indoor/Children's Area: Indoor activity space for school age children is physically separate from space used by children in the preschool and infant center components. School age center is equipped with appropriate furniture and equipment. LPA observed a dramatic play area, with dress up clothes, four benches and tables for school work and activities, books, art supplies and board games. Furniture is maintained in good repair and safe condition (age appropriate). Toys are safe and LPA did not observe sharp points or edges, or small parts that could be swallowed. Per Administrator equipment, toys and furniture is sanitized daily. LPA and Administrator discussed the staff/child ratio and based on the conversation is not exceeding the approved capacity for the facility.
Furniture and equipment were inspected for age appropriateness and good repair. LPA observed the dramatic play kitchen equipment inside classroom had accumulated dust and dirt. Per Administrator the toys are used outside by the children. LPA advised the Administrator to have the items washed off and/or sanitized prior to the toys being brought back inside for play. LPA advised that all staff should be monitoring the play equipment each day to ensure items are in good condition, clean, safe and free of sharp or loose parts. An advisory notice was issued Drinking water is available inside the classroom via individual cups and a pitcher of water. Each school age child has an individual cubbies labeled with their name for the storage of personal items. Report continued on page two
Carissa Bell
Kendal Zirbes
DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 05/20/2022 04:50 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 05/20/2022 at 02:46 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LITTLE MOUNTAIN PRESCHOOL
FACILITY NUMBER: 367750026

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above when the closet door in room 6 was unlocked. Paint, WD40, Lyson, and cleaning solutions were located in this area. Since the door was unlocked the items were accessible to the children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/27/2022
Plan of Correction
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The closet door was immediately locked. Per Administrator she will notify all staff today of the unlocked door. A training regarding health and safety will take place next week. A copy of the staff training will be set to CCL.
Type B
Section Cited
CCR
101238.2(e)
Outdoor Activity Space
(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, the licensee did not comply with the section cited above when the area around and under the swing was equipped with less than a half inch of wood chips/ sand. Less than a half inch of cushioned material will not absorb a fall, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/20/2022
Plan of Correction
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Per Administrator, the swing will be removed today and the swing will not be utilized until additional wood chips are purchased. Administrator will send LPA a picture of the new material.
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:Carissa Bell
TELEPHONE:
LICENSING EVALUATOR NAME:Kendal Zirbes
TELEPHONE:
LICENSING EVALUATOR SIGNATURE:
DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2022


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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: LITTLE MOUNTAIN PRESCHOOL
FACILITY NUMBER: 367750026
VISIT DATE: 05/20/2022
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Report continued from page one
Per Administrator all chemicals and cleaning materials are stored in a locked closet within classroom 6. During the inspection LPA turned the closet door knob to ensure the door was locked. When LPA turned the handle the closet door opened. LPA observed the following items in the unlocked closet: paint cans, WD40, glade, Lysol and cleaning solutions. Due to the door being unlocked at the time of this inspection the chemicals were accessible and poses a potential risk to the children in care. A Type B citation was provided since there were zero school age children present, refer to LIC 809D. The door was immediately locked by the Administrator. The Center does not have a fireplace. The building has central heating and air conditioning units were secured in the windows of the Center. The room temperature was comfortable at the time of this inspection. LPA observed the carbon monoxide, Fire Extinguisher and smoke detector in working condition. There is a working telephone on the premises. There is an isolation room for ill children. The classroom had a complete first aid kit. LPA observed sign in/out sheets at the entrance to the facility. LPA observed the staff were signing the children in and out following transportation to school. COVID-19 posters were posted. No smoking is allowed on the premises. The bathroom utilized by the school age children was in safe and sanitary operating condition at the time of this inspection.

Children/Infant are inspected for illnesses (wellness policy) as they arrive. Per Administrator at this time zero medications are provided to the school age children. If medications were are administered they would be provided only with parent's written permission and a doctor's note. Staff document when the medication is administered. Facility was advised that the medication must be properly labeled and stored in its original container. All medications are stored in a locked refrigerator within the staff office.

Napping: At the time of this inspection, zero school age children were at the facility during nap times. Quite time is provided.

The facility participates in the food program and provides meals and snacks for the children.

Sign in and out sheets were reviewed and appeared up to date. LPA observed Licensing and Parent boards to be incompliance including the required posting. Per conversation with the Administrator, the last disaster drill was conducted in May 2022. LPA observed written documentation of the May 2022 drill.



Report Continued on page three
SUPERVISOR'S NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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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: LITTLE MOUNTAIN PRESCHOOL
FACILITY NUMBER: 367750026
VISIT DATE: 05/20/2022
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Report continued from page two

Child File Review: LPA reviewed a total of 10 school age files. All files reviewed were complete and contained all required information.

Staff Files: LPA reviewed three staff files. All staff files contained the required information (Qualifications, immunization, licensing forms (LIC9108, Mandated Reporter, LIC508, LIC308).

Facility Records: LPA observed the Roster to be complete and current. The Administrator and additional staff have current CPR/First Aid with an expiration of 11/02/2022.

Posting Requirements: Center has required posting posted (license, PUB 393, LIC610, car seat law information).

LPA verified the Center has telephone service during the inspection.

Outdoor: Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Outside area is completely fenced. Activity space is physically separate from the space used by children in the preschool and infant component. The outdoor area, has grass, dirt, and cement for active play. Per Administrator a portable pop up shade is set up when required. At the time of this inspection, the Center had one swing. LPA observed scattered wood chips, grass and dirt/sand measuring less than a half inch under and around the one swing in the school age outdoor play area. Based on LPAs observation, the less than half inch of material around or under the swing would not absorb a fall. The facility was issued a type B citation, as this poses a potential risk to the children in care, refer to LIC 809D. LPA observed the wooden barrier surrounding the air conditioning unit was missing half of a wooden board. The missing area was approximately 24 inches in height by 3 inches wide. In addition, the white paint of the wooden boards was chipping on approximately 22 of the wooden boards. Based on the ages of the school age children, this observation does not pose a risk at this point. However the Administrator was advised that continued wear could pose a risk to the children in care. A technical advisory was issued. Per conversation with the Administrator, the staff take a pitcher of water and cups outside therefore drinking water is available.

Report continued on page four
SUPERVISOR'S NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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: LITTLE MOUNTAIN PRESCHOOL
FACILITY NUMBER: 367750026
VISIT DATE: 05/20/2022
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Report continued from page three

Food Service: There is a kitchen area used by all three components The kitchen door remains locked at all time. Chemicals were located under the sink and were separate from the food cabinets. Based on LPA observation today, the food was prepared and served in a safe manner. Menus were posted in the lobby and kitchen. Allergy lists are posted in kitchen. LPA observed an appropriate amount of food and snacks for children during the inspection.

Transportation: The facility provides transportation to and from school. LPA inspected the facility vehicle, a seven passenger van. LPA observed two booster seats in the van. The booster seats were equipped with expiration dates, however LPA was unable to determine the expiration on the booster. LPA and Administrator discussed the booster seats being used for transportation. LPA advised the Administrator to ensure that all vehicle occupants are secured in an appropriate restraint system per 101225 (d) Transportation. Administrator was advised that LPA may return to the facility if further follow up is warranted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA reviewed with Administrator the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.


LPA discussed the safe sleep regulations with Administrator 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 the Administrator 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. Report continued on page five
SUPERVISOR'S NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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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: LITTLE MOUNTAIN PRESCHOOL
FACILITY NUMBER: 367750026
VISIT DATE: 05/20/2022
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Report continued from page four

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

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The licensee/Applicant shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Based on LPA observations and file review, citations were issued during the inspection today. Refer to LIC 809D for further information.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, April Dogero.
SUPERVISOR'S NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
LIC809 (FAS) - (06/04)
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