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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750081
Report Date: 12/27/2021
Date Signed: 12/27/2021 04:12:23 PM

Document Has Been Signed on 12/27/2021 04:12 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:PURE & SIMPLE ACADEMY & CHILD CARE CENTERFACILITY NUMBER:
197750081
ADMINISTRATOR:AGUIRRE, SANDRA LONAFACILITY TYPE:
850
ADDRESS:43301 DIVISION ST SUITE 101TELEPHONE:
(661) 524-1042
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 0DATE:
12/27/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Debbie CastilloTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (s) Maddox and Tamayo met with Director, Debbie today for the purpose of conducting a pre-licensing/capacity increase inspection. Center is currently licensed for 45 Preschool children and they are requesting to increase the capacity to 75. The following rooms were measured today to incorporate with the current preschool component:

Rooms 303 and 304
303 measured 849/35 = 24 children
304 measured 827/35 = 24 children
Both classrooms have 1 bathroom with 1 toilet and 1 sink= 30
Outside play space measured 20 X 60 =1200/75= 16 & 40 X 10 = 400/75=5
Total outdoor space equals 21 children

LPA's observed carbon monoxide detectors, fire extinguishers, and first aid kits in all classrooms, all electrical outlets were plugged, changing tables were in arms reach of a sink, age appropriate toys and play equipment (indoors). Fire clearance was received for the requested capacity of 93

With measurements, toilets and sinks available, center can accommodate 30 additional Preschool children with a grand total of 75. Director will request a waiver to use Room 306 an alternate Indoor/Outdoor space, measurements for this classroom were as follows: 29 X 70 =2,030/35 = 58

The following are needed:
Updated LIC 200A
Updated LIC 500
COVID postings need to be placed in the new building
Room 302 needs a changing table and portable sink


SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2021
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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