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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417396
Report Date: 01/31/2023
Date Signed: 01/31/2023 03:50:07 PM

Document Has Been Signed on 01/31/2023 03:50 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MONTESSORI OF VALENCIAFACILITY NUMBER:
197417396
ADMINISTRATOR:ERIN JOHNSONFACILITY TYPE:
850
ADDRESS:24925 ANZA DRIVETELEPHONE:
(661) 257-4161
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY: 138TOTAL ENROLLED CHILDREN: 138CENSUS: DATE:
01/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Erin Johnson, DIrectorTIME COMPLETED:
02:10 PM
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On January 31, 2023, Licensing Program Analyst (LPA) Villa and met with the facility Director Erin Johnson for the One Year Required inspection. A tour of the facility was conducted. Upon arrival LPA observed 2 classrooms in use with a total of 119 children in care. There were 12 teachers on the premises and the Director working under the Preschool License. The facility also holds an Infant license, and the two programs are physically separated on the premises. The hours of operation are 6:30 AM- 6:30 PM Monday - Friday. Incidental Medical Services (IMS) were discussed.

Indoor/Children’s Area: Child care center is clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labeled with name) for his/her clothing, personal belongings and or bedding (stored separately).

Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors and outdoors (Drinking water is provided by parents in reusable cups and filtered water is provided and available as necessary). LPA observed a sufficient quantity of cribs and cots available for napping children. All materials and surfaces are toxic free are inaccessible, no fireplace. There are working carbon monoxide detectors, smoke detectors and Fire Extinguishers. There is a working telephone.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MONTESSORI OF VALENCIA
FACILITY NUMBER: 197417396
VISIT DATE: 01/31/2023
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Restrooms: LPA inspected and observed three sinks and three toilets in each classroom which were clean and orderly. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate. There is an isolation area for children who become ill while in care located in director’s office, facility maintains a comfortable temperature at all times, first aid supplies (thermometer, bandages, scissors), sign in/out sheets available and completed daily. There is no smoking on the premises, and daily inspection for illness. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Napping: LPA observed children's personal sheets in each cubby labeled with child's name. LPA observed a sufficient amount of cribs and cots available for each child.

Outdoor: The facility has 4 playground area for preschool and toddler children. Outside play area is completely fenced. Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. There is wood chips for cushion and grass areas for active play. The area was observed to be free of debris, free from hazard, holes, broken items, debris, cushioning material underneath. No bodies of water were observed. There are areas for shade and rest. Children have reusable cups and are provided with water. LPA observed locked storage shed for play equipment and seasonal decorations which were inaccessible to children in care.

Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file.



Facility Records: Roster, fire/disaster drill log last completed on 11/21/2022, CPR/First Aid, and mandated report training were reviewed.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394L), emergency disaster plan, earthquake preparedness checklist.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MONTESSORI OF VALENCIA
FACILITY NUMBER: 197417396
VISIT DATE: 01/31/2023
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Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. All staff files were reviewed for completeness and compliance. Director Erin Johnson’s CPR/First Aid expires on 6/25/2024. Mandated reporter training expires 11/12/2023.

Electrical outlets are inaccessible, recalled and or prohibited toys or sleep/play equipment were observed on the premises. There are no window cords accessible to children. Children nap on cots.

Sign in and out sheets were reviewed. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Roster current.

Teacher child ratios were observed and staff name recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate.



Health Related Services: Medications inaccessible to children; all prescription and non-prescription medications have child’s name and are dated; written consent and instruction from child’s representative, a plan to document and report to child’s representative when medication is administered to a child; IMS plan on file (if applicable).

Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is administered only with parent's written permission (licensing medication form- LIC9221 - also used). Per Director, she does not have children enrolled who require medication. LPA advised the Director must administer medication, and document the dosage, date and time onto a log. Medication can be brought and taken home by the parent daily. Medication will be properly labeled and stored in its original container. There is a separate area for isolation and care of ill children in the Director's office.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MONTESSORI OF VALENCIA
FACILITY NUMBER: 197417396
VISIT DATE: 01/31/2023
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This facility provides Incidental Medical Services – IMS. Currently no 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 Care Centers and the ADA, available at: http://www.ada.gov/childquanda.htm

Food Service: There is a clean area with refrigerator and microwave for storing infant food and milk. Each infant has a labeled storage basket in each refrigerator. The facility currently has a food program. Lunch and snacks are provided.

Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.



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. Director 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 child care center 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.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MONTESSORI OF VALENCIA
FACILITY NUMBER: 197417396
VISIT DATE: 01/31/2023
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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


A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiency was cited today. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Exit interview conducted and report was reviewed with the facility’s Director, Erin Johnson. This report was read and provided to along with her appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC809 (FAS) - (06/04)
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