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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750145
Report Date: 12/20/2023
Date Signed: 12/20/2023 05:18:27 PM


Document Has Been Signed on 12/20/2023 05:18 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:ACADEMY OF EXCELLENCE PRESCHOOLFACILITY NUMBER:
197750145
ADMINISTRATOR:LORIENA FRANCISCOFACILITY TYPE:
840
ADDRESS:725 EAST AVENUE JTELEPHONE:
(661) 206-9433
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:15CENSUS: 3DATE:
12/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Chauncy SmithTIME COMPLETED:
05:20 PM
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On 12/20/2023, at 3:50 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the facility owner, Chauncy Smith to conduct an unannounced One Year Required inspection for the School age license in accordance with the facility sketch. A tour of the facility was conducted. LPA observed a total of 3 school age children in the classroom (Enchanting Eagles) with 1 teacher providing care and supervision. The hours of operation are 6:30 A.M. - 11:00 P.M., Monday - Friday. Incidental Medical Services (IMS) was discussed.

Indoor/Children’s Area:
Child care center is clean, safe, sanitary and in good repair; floors of all rooms have a surface that is safe and clean, cleaning compounds and other items that could pose hazard are inaccessible, furniture and equipment are maintained and in good condition, free of sharp lose or pointed parts; tables/chairs provided to meet children’s needs; LPA observed books, puzzles, and other curriculum. Per Director Jessica Santos, teacher teach school age children with their homework and other projects after school. All play equipment and materials used by children are age appropriate. Each child has an individual or portable storage space (cubby, individually labelled with name) for his/her clothing and personal belongings. There is a working telephone. Electrical outlets are inaccessible and has plastic covers. Recalled and or prohibited toys or sleep/play equipment were not observed on the premises. There are no window cords accessible to children.

LPA observed the trash bin for solid waste in the classroom have a missing lid. LPA advised the director to put a tight-fitting lid on the trash bin. Drinking water is provided in every classroom with the use of a Culligan water dispenser and disposable cups. Per Director, water fountains are currently not being use in the facility. LPA observed two sleeping cots available for napping school age children. All materials and surfaces are toxic free and are inaccessible. There is no fireplace in the facility. The center has an internal pull-down fire alarm system and fire extinguishers (service date was on 04/04/2023, reading in green, checked at 10:07 A.M.). Carbon monoxide devices are in operable condition (checked at 3:44 P.M.).

Restrooms: LPA inspected and observed a total toilet and sink in the bathrooms for school age children.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
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: ACADEMY OF EXCELLENCE PRESCHOOL
FACILITY NUMBER: 197750145
VISIT DATE: 12/20/2023
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The LPA observed liquid soap, toilet paper, and trash bin. Water temperature is appropriate.

There is an isolation area for children who become ill while in care and is located in the main office. The facility maintains a comfortable temperature at all times, first aid supplies (first aid manual/guide, bandages, scissors, gauze), sign in/out sheets are available and completed daily. The director was advised to put tweezers inside the first aid kit.

Smoking is prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.

Napping: LPA observed 2 sleeping mats and are maintained in good condition, wiped/cleaned/disinfected daily, or when soiled and there is no contact with other children bedding. Per director Smith, mats are only used when school age children wanted to sleep.

Outdoor: The facility has one playground area for school age children. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. The area was observed to be free of debris, free from hazard, holes, broken items, debris. The area consists of dirt and woodchips. LPA observed slides, swing, and an airplane seesaw. According to the Director Smith, drinking water is provided during outdoor plays. Staff bring a water pitcher and disposable cups when they play outside.

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



Health Related Services: According to Director Smith, they were providing medications to children in care. LPA observed the facility has LIC9221 Parent Consent for Administration of Medications and Medication Chart.

Children are inspected for illnesses (wellness policy) as they arrive. Children were check with regards to their body temperature and visual.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: ACADEMY OF EXCELLENCE PRESCHOOL
FACILITY NUMBER: 197750145
VISIT DATE: 12/20/2023
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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

Food Service: There is a clean microwave, refrigerators, and freezers available in the facility.

Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance for staff, criminal record statement, statement acknowledging suspected child abuse and mandated reporter trainings were observed in file. However, staff #3 is missing the following documents: 1) CPR/First Aid training and 2) Immunization records.



Facility Records: Roster, fire/earthquake drills were completed on 09/11/2023 at 11:34 A.M. and 06/23/23 at 11:15 A.M. The facility is using an emergency alarm system.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty. The following were observed posted as required: facility license, PUB 269 Child Passenger Restraint System, Parent’s Rights Poster (PUB 393), and emergency disaster plan,

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. The director was advised to put tweezers inside the first aid kit.

Mandated Reporter Trainings was completed on 03/15/23. During this inspection, two staff members have current CPR and First Aid training.

Sign in and out sheets were reviewed. The facility is using sign in and out sheet. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: ACADEMY OF EXCELLENCE PRESCHOOL
FACILITY NUMBER: 197750145
VISIT DATE: 12/20/2023
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Director was 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 a day care center. 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 day care center, 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.

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

Type B deficiencies were cited during this inspection.

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. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8 A.M. -5 P.M.



Exit interview conducted and a copy of this report, Notice of Site Visit, and appeal rights were provide to Director Chauncy Smith.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 12/20/2023 05:18 PM - It Cannot Be Edited

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: ACADEMY OF EXCELLENCE PRESCHOOL
FACILITY NUMBER: 197750145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(f)(1)
Fixtures, Furniture, Equipment, Equipment and Supplies
(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the facility did not comply with the section cited above by failing to provide a tight-fitting lid of the trash bin for solid waste inside the school age classroom which posed a potential Health, Safety or Personal Rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Director/staff will email photos of the trash bin with tight-fitting lid to LPA.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the facility did not comply with the section cited above by failing to provide the staff immunization records which posed a potential Health, Safety or Personal Rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Director/staff will email copies of the immunization records for the staff to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6


Document Has Been Signed on 12/20/2023 05:18 PM - It Cannot Be Edited

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: ACADEMY OF EXCELLENCE PRESCHOOL
FACILITY NUMBER: 197750145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(b)(6)
Child's Records
(b) Each record shall contain information including, but not limited to, the following: (6) A signed copy of the admission agreement specified in Section 101219.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the facility did not comply with the section cited above by failing to provide Admission Agreement for child #4 and #5 which posed a potential Health, Safety or Personal Rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Director/staff will email copies of the Admission Agreement for child #4 and #5 to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6