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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493008
Report Date: 03/17/2023
Date Signed: 03/17/2023 06:14:21 PM

Document Has Been Signed on 03/17/2023 06:14 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:MAGIC CAROUSEL MONTESSORI PRESCHOOLFACILITY NUMBER:
197493008
ADMINISTRATOR:SHIRLEY JOHNSONFACILITY TYPE:
830
ADDRESS:17956 SIERRA HIGHWAYTELEPHONE:
(661) 298-4065
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
03/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Shirley JohnsonTIME COMPLETED:
06:15 PM
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On 3/17/2023, Licensing Program Analyst (LPA)Isabel Ortega conducted an unannounced annual random inspection at the infant program. LPA met with Director, Shirley Johnson who guided Analyst on a tour of the facility. Upon arrival LPA observed 7 infants present with 2 staff providing care and supervision. Infant care is provided in one classroom referred to as the Itty Bitties.

A tour of the infant classrooms was conducted. The infant indoor and outdoor activity space is physically separate from the space used by other day care children. Infant furniture and equipment, including cribs and mattress are age appropriate and in good repair. Infant changing tables have padded surface no less than one inch thick, covered with washable vinyl or plastic, and have raised sides at least three inches high. Toys are safe, without sharp points, edges, splinters or small parts. Facility is in compliance with staff infant ratios. All infants including those napping in cribs are under visual observation at all times. Needs and Services plans, Individual Sleeping Plans(LIC9227) and individual infant Sleeping logs were observed in the classrooms with Staff’s 15 minute checks initials.

Facility operates Monday through Friday from 6:00 a.m. to 6:00 p.m. Facility provides breakfast, lunch afternoon snack and evening snack for children.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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: MAGIC CAROUSEL MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493008
VISIT DATE: 03/17/2023
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Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage with infant's name labeled for Infants’ belongings. Classroom consists of filtered water with individual bottles/zippy cups for children. Sanitized and sterilized bottles are utilized for infants on milk formula or/and breast milk (bottles are labeled). One bottle is utilized for the milk formula and another is utilized for filtered water.


Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inspected for inaccessibility to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

LPA observed age appropriate toys and materials. There is a changing table is located in the classroom near a sink and diaper supplies. Sufficient napping equipment was observed (cots, mats and cribs). Trash bin was observed covered. Staff use separate staff bathrooms. Operable carbon monoxide detector and smoke detector was observed, tested and meeting the Fire Marshal standards. The center also has a operable (2A10BC) Fire Extinguisher reading in green and last serviced 12/15/2022.

There is a refrigerator in the classroom for storing formula, facility also has a fully functional kitchen area. Per director, there are currently no infants enrolled with allergies, however, there is space for an allergy list to be posted on the refrigerator door in the kitchen.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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: MAGIC CAROUSEL MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493008
VISIT DATE: 03/17/2023
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All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. Storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair.

Monthly menu was observed visible to parents. Chemicals and cleaning solutions are kept separate from the food.
Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. There is a play area with padded surface underneath to absorb falls and a shaded area The area was observed to be free of debris. Play area was inspected for hazards and inaccessibility to bodies of water. There is no body of water on the premises.

Storage area for poisons disinfectants, and hazardous items are inaccessible to children. Fire drills and earth quake drills are conducted every 6 months last drill conducted was recorded on 2/27/2023 at 9:27 a.m.

LPA observed staff files and infant files and they were found to be in compliance. LPA observed Director’s CPR/First Aid Expires 07/25/2023. All staff have a current CPR/First Aid card/certificate on file. Staff records reviewed contain documentation of the educational background (transcripts/Child Development Permits), training, and/or experience, a Health Screening/TB test and immunization records to meet SB 792. All staff have the Child Care Provider Mandated Reporter training certificate in the file, Director's Mandated Reporter certificate is dated 7/20/2021.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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: MAGIC CAROUSEL MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493008
VISIT DATE: 03/17/2023
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Teacher child ratios were observed. The parent board was reviewed and has all of the required forms posted. Sign in/sign out sheets are located in front of the facility. A sample of staff and children's files were reviewed.
Per Director at the moment there are no infants currently taking medications at the facility. The staff room is utilized as an isolation area for ill children.

The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

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.



LPA discussed the safe sleep regulations with Director 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 Director 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.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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: MAGIC CAROUSEL MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493008
VISIT DATE: 03/17/2023
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The following Incidental Medical Services (IMS) were discussed.
This facility provides 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 Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

All staff are required to take 3-hour Mandated Reporter training every 2 years. www.mandatedreporterca.com. Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations. Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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: MAGIC CAROUSEL MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493008
VISIT DATE: 03/17/2023
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Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000. For additional information and forms visit our website at: www.cdss.ca.gov 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.

Per Title 22 Regulations facility is in compliance, no deficiency will be issued today.

Exit interview conducted, report was reviewed with the Director Shirley Johnson. Copy of this report, notice of site visit and appeal rights were provided on this day.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC809 (FAS) - (06/04)
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