197750129-5-9-2022-12-CC-DMAX-CE9R8V-20220509124831

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750129
Report Date: 04/12/2022
Date Signed: 05/09/2022 12:48:37 PM

Document Has Been Signed on 05/09/2022 12:48 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 INC		FACILITY NUMBER:	197750129
ADMINISTRATOR:	SANDRA LONA AGUIRRE		FACILITY TYPE:	850
ADDRESS:	43301 DIVISION ST, SUITE 101		TELEPHONE:	(661) 524-1042
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 14	DATE:	04/12/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Applicant Lona Aguirre		TIME COMPLETED:	02:37 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	Licensing Program Analyst (LPA) Maddox, Debbie and Applicant Lona Aguirre today for the purpose of re-licensing Pure and Simple due to a change of ownership (The Applicant is now a Corporation). During this inspection, the facility sketch was reviewed, and the center was toured in it's entirety. As you enter the center, there are 2 offices (on the left and right); LPA observed all of the required documents posted and visible upon entry: Parent's Rights poster (PUB 393), Personal Rights form (LIC 613A), menus, child passenger restraint poster (PUB 269), daily activity schedule, Emergency Disaster Plan (LIC 610) and Earthquake Preparedness Checklist (LIC 9148) and Lead water safety poster. There are 2 bathrooms in the hallway (1st bathroom is designated for staff, 2nd bathroom is designated for PS children and has 1T/1S); as you turn the corner the right, there is another PS bathroom to the right that has 2U/1T/3S (ratio for 30 children); There are additional bathrooms located off of the play yard, the center has exclusive use of these bathrooms. There are 2 separate bathrooms (girls and boys): The girls bathroom has 3T/3S and the boys bathroom has 2S/1U/ and 2T. The Total Capacity with bathrooms is: 105 These classrooms are located in the main building Room #2 (2 year olds): Empty during this inspection

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

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: PURE & SIMPLE ACADEMY INC	FACILITY NUMBER: 197750129
	VISIT DATE: 04/12/2022

NARRATIVE

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Room #3 (3 yr olds): there were 12 napping children present with 2 staff
Room #4 (4 yrs olds), present were 6 children with 2 StaffThe corner room is a Therapy Room and also designated as an overflow room for SA children
Room #7: designated as an indoor play yard
Room #302 (located in an adjacent building) - empty during this inspection.

These are the capacity's for each classroom:
Room #2 has a capacity for 13 children
Room #3 has a capacity for 20 children
Room #4 has a capacity for 21 children
Room # 302 has a capacity for 28 children
TOTAL: 82

Rm# 306 = 69L X 29W = 2,001/35 = 57
The Outdoor play yard:
School age and Preschool Yard (Middle Area)
24W X 42L = 1,008/75= 13 (FT)
22W X 32L = 704/75 = 9 (BK)
Total Outdoor Space = 22

OUTDOOR ACTIVITY SPACE:
The outdoor play area is surrounded by fencing. There's natural shade available on the are shaded areas including trees, chairs and canopies for shade. Applicant has installed rubber matting on the rear play yard.

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

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: PURE & SIMPLE ACADEMY INC	FACILITY NUMBER: 197750129
	VISIT DATE: 04/12/2022

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LPA inspected the Fire extinguishers throughout the center, last service date was 11/21, all were in the "green"; LPA observed working Smoke detectors and Fire Alarm system (hard wired) and separate Carbon monoxide detectors; Applicant was informed to conduct and maintain Fire/Earthquake drill logs. The facility will be using electronic sign in and sign out system. LPA explained that a backup system must be in place if the electronic system is not available.

Children that require IMS will have their medications administered by the director and assistance director. This facility has a IMS plan for EpiPen, Nebulizer, and Inhaler. This facility will provide Incidental Medical Services – IMS as specified in their Parent Handbook. 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

Applicant was reminded to access the licensing website at ccld.ca.gov to obtain information about the most recent regulatory changes and the Quarterly Updates.

Applicant was reminded that capacity and ratio must comply with specified regulations. LPA informed Applicant that current staff can be re-associated to the new facility # through Guardian.

Applicant is requesting a capacity of 60 PS children, when fire clearance is received, and fingerprints transferred, center will be licensed. Exit interview was conducted, report was read and a copy was given to the applicant.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

LIC809 (FAS) - (06/04)

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