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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750092
Report Date: 05/24/2022
Date Signed: 05/24/2022 05:29:10 PM

Document Has Been Signed on 05/24/2022 05:29 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:GUIDEPOST MONTESSORI AT PLUM CANYONFACILITY NUMBER:
197750092
ADMINISTRATOR:AARON BAILEYFACILITY TYPE:
850
ADDRESS:19141 SKYLINE RANCH RDTELEPHONE:
(949) 354-2259
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 43DATE:
05/24/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:34 PM
MET WITH:Gina Castello, Head of SchoolTIME COMPLETED:
05:30 PM
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On May 24, 2022 Licensing Program Analyst (LPA) Monique Ayala and Licensing Program Manager (LPM) Mariela Ramon met with Head of School for the purpose to follow up on Unusual Incidents that occurred on 03/29/2022, 03/31/2022 and 04/06/2022 and were reported to the Department within the required deadlines. Upon arrival LPA and LPM observed 43 preschool children with 5 teachers along with the facility Head of School.

On 03/29/2022, child #1 tripped and fell while walking back to the table inside the classroom. As a result, child #1 hit the right side of her head and ear on the cabinet. Staff 1 was in close proximity to the child 1. During the time of the incident there were 24 children with 3 staff members. No marks or bruises observed. Ice pack applied.

On 03/31/2022, child #2 hit child #3 with a small shovel during gardening time. Child #2 did not sustain any bruises, marks or injuries. Staff 1 attended to child 2 and child 3 and explained to children how to use gardening tool. There were 40 preschool children with 4 staff members. An ice pack applied.

04/06/2022: child #4 was sitting on the hill with child #5. A fly kept flying around them. Child #5 kicked the fly and accidentally hit child #4 on the face. As of result child #4 had a red mark on the cheek. An ice pack was applied
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: GUIDEPOST MONTESSORI AT PLUM CANYON
FACILITY NUMBER: 197750092
VISIT DATE: 05/24/2022
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The unusual incident reports follow up consisted of interviews conducted with staff, parents, and review of children’s files.

The unusual incident follow-up revealed there is no information to establish that the children’s incidents was the result of lack of care and/or supervision. No deficiency will be cited. Facility is encouraged to continue to report incidents that occur in the facility.

A follow up visit will be conducted to follow up on two incidents that occurred on 03/29/2022 concerning a child that was hit in the head with a number rod and 04/06/2022 concerning a child that fell off a picnic bench and hit their head on the ground. The incidents were reported timely to the department.

Exit interview was conducted and a copy of this report was provided along with notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC809 (FAS) - (06/04)
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