197411390-9-8-2022-12-CC-EROZ-CJ3LMK-20220908085248

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197411390
Report Date: 09/06/2022
Date Signed: 09/08/2022 08:54:25 AM

Document Has Been Signed on 09/08/2022 08:54 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:	LANCASTER UNITED METHODIST CHILDRENS CENTER		FACILITY NUMBER:	197411390
ADMINISTRATOR:	DAMON, TAMMY		FACILITY TYPE:	830
ADDRESS:	918 W. AVE J		TELEPHONE:	(661) 942-0812
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 15	DATE:	09/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:36 PM
MET WITH:	Tammy Damon		TIME COMPLETED:	01:45 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	On 09/06/22 at 12:36 p.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced inspection at the above Facility to assess the Center's operation of their Infant Program and current physical plant status. Also, to evaluate the Center's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. The LPA met with the Facility Director, Tammy Damon, the purpose for the inspection and provided a copy of the Entrance checklist form, LIC 125.. The LPA was provided with copy of the Child Care Center children rosters for each classroom (LIC 9040), Personnel Report (LIC 500). The Center maintains on file a current Designation of Facility Responsibility (LIC 308), Sign in and Sign Out Rosters, current Plan of Operation and Parent Handbook. At 10:15 a.m. LPA Rodriguez along with the Director and Assistant Director, Nicole Medina conducted a walk trough of the entire Facility. The facility license is posted on a prominent place of the Center. During the walk through/inspection of the Facility the LPA discussed observations of Title 22 requirements. The Center is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. First aid kits are available and complete (inaccessible to children/infants.) The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Center conducts and records emergency disaster drills. The parents board was reviewed and has all the required items posted in an area accessible to parents. The following items are posted: PUB 393, Notification of Parent’s Rights Poster; PUB 269, Child Passenger Restraint System poster; LIC 610, Emergency Disaster Plan, LIC 9148, Earthquake Preparedness form; LIC 613A, Personal Rights. The Parents Handbook is available.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: LANCASTER UNITED METHODIST CHILDRENS CENTER	FACILITY NUMBER: 197411390
	VISIT DATE: 09/06/2022

NARRATIVE

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Mattresses are made specifically for the size crib or play yard in which they are placed. Fitted sheets are immediately replaced when wet or soiled. Each infant's bedding is used for each individual child/infant only. Bedding that touches the infant’s skin are cleaned at least weekly or before use by another infant. Soiled bedding is placed in a closed container and made inaccessible to infants until washed. Cribs or play yards are free from all loose articles and objects. Pacifiers are not allowed in the crib, but when allow the pacifier does not have any thing attached and each pacifier is specific to the infant it is given to. There are no bumper pads on any of the cribs or play yards and there are no objects hanging above or attached to the side of the cribs. Staff is also familiar with the guidelines established by the American Academy of Pediatrics to help reduce the risk of Sudden Infant Death Syndrome (SIDS) when caring for infants.

Infants up to 12 months of age have completed their Individual Infant Sleeping Plan [LIC 9227] Infants needs and services plan are included in each infant file.

Regarding COVID-19, the LPA advised the Director to continue to follow COVID-19 requirements as applicable. However, If there are differing requirements between the most current CDC, CDPH, CDSS, DDS, Cal/OSHA, and local health department guidance or health orders, to follow the strictest requirements.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care; therefore, no deficiencies were cited. Overall, the Center is in compliance with Title 22 regulations.

An exit Interview was conducted and a copy of this Report, and Notice of Site Visit were provided to the Facility Director.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: LANCASTER UNITED METHODIST CHILDRENS CENTER	FACILITY NUMBER: 197411390
	VISIT DATE: 09/06/2022

NARRATIVE

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Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children. Furniture and equipment were inspected for age appropriate and observed to be in good repair and defects free. Sign in/out rosters, telephone service, heating, lighting and ventilation were evaluated and no defects were noted. There are clean safe and sanitary individual space/cubbies with children's names. The facility utilizes a designated isolated area to isolate ill children. The toys and material use for instructions meet regulatory requirements. The trash cans contain tight lids. All toilets, hand washing, and bathing facilities shall be in safe and sanitary operating condition..

The outdoor play areas were noted free of hazards. Playground items are properly secure and free of loose or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Climbing structures are age appropriate, play equipment is properly securely and anchored with adequate resilient. There is cushioning material underneath and around the inside and outside play areas. On the outside play area, there is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed.

LPA observed staff providing care and supervision children. The Staff was monitoring food intake or special diets; assisting in diapering, toileting, dressing, and other personal hygiene needs; etc. At no time the LPA observed no child being unsupervised. The LPA advise the Director to ensure every one working at the center is current in all required training and properly qualified to provide quality care and safe supervision to children in care.

The LPA conducted a review of several Staff records. The review included, but was not limited to the following: Criminal record statements (LIC 508) Record of submission of Child Abuse Index Checks. Staff qualification. Reference letters and verifying work experience on file. Health clearances, including TB clearances. Pediatric CPR/first aid cards for designated staff. 15 hours of health & safety training for designated Staff. Notice of Employee Rights receipts (LIC 9052). Statement Acknowledging Requirement to Report Suspected Child Abuse. (LIC 9108) and Mandated Reporter Training certificate. Copy of driver’s license. Personnel Record (LIC 501) or application/resume with required information.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: LANCASTER UNITED METHODIST CHILDRENS CENTER	FACILITY NUMBER: 197411390
	VISIT DATE: 09/06/2022

NARRATIVE

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A review of staff records on today's date indicates that the Center staff, and other individuals listed on the LIC 500, Personnel Report and other personnel working at the Facility have received Criminal Record, FBI, DOJ and Child Abuse Central Index Check clearances or exemptions

Also, a review of several Children records was conducted. The review included, but was not limited to the following: Admission agreements. Needs and Services Plans for infants,. Immunization Records (“blue cards; PM 286) for non-school-age children. Authorizations for dispensing medications signed by parents. Identification and Emergency Information forms (LIC 700) Child’s Pre-admission Health History- Parents’ Report forms (LIC 702) Child’s Pre-admission Health Evaluations- Physician’s Report forms (LIC 701)
Documentation required for health-related services (e.g., blood-glucose monitoring, nebulizer care LIC 9166, gastrostomy-tube care LIC 701A and LIC 701B) Consent for Emergency Medical Treatment forms (LIC 627) 6]
Unusual Incident/Injury or Death Reports (LIC 624) Parents’ Rights (LIC 995) receipts, signed and dated.
Personal Rights receipts (LIC 613), signed and dated.

At the time of the inspection, the LPA observed appropriate Staffing Ratio and Capacity: Staffing ratios per number of children in care was in compliance.

Per Director and Staff interviewed all children in care are accorded with their Personal Rights. Each child in the facility receiving services is treated with dignity and respect and respect all their personal rights.

The Facility Infant Component has appropriate materials for napping. Cots, mats, cribs and/or playpens are available. All windows are free of cracks, bugs and debris. Hanging window blinds cords are inaccessible to children. The Facility has a designated area for children showing signs of illness and a plan to act accordingly.
Regarding infant safe sleep, Facility Staff is aware of current Safe Sleep Awareness. There is one crib or play yard (pen) for each infant who is unable to climb out of the crib or play. All cribs and play yard meet the United States Consumer Product Safety Commission safety standards. Placement of cribs or play yards do not hinder entrance or exit to and from the space where infants are sleeping. Mattresses are firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC809 (FAS) - (06/04)

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