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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750150
Report Date: 12/01/2022
Date Signed: 12/01/2022 03:51:12 PM

Document Has Been Signed on 12/01/2022 03:51 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:ARK ACADEMYFACILITY NUMBER:
197750150
ADMINISTRATOR:VONDA PERRYFACILITY TYPE:
830
ADDRESS:1146 COMMERCE CENTER DRIVETELEPHONE:
(661) 504-4034
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY: 6TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
12/01/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Vonda Perry and Rivka JonesTIME COMPLETED:
04:05 PM
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Licensing Program Analyst (LPA) Maddox conducted an announced visit today and met with Vonda Perry and Rivka Jones for the purpose of conducting a Pre-Licensing inspection for an Infant Component. Applicant is requesting to be licensed for 6 Infants. The hours of operation are Monday through Saturday from 5:00 am to 8:00 pm. This center is located within a strip mall.

INDOOR ACTIVITY SPACE:

· A comfortable temperature for children shall always be maintained.


· Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts.
· Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored in the kitchen (the kitchen door must remain locked while children are present - there is a sign on the door)
· There are fully stocked first-aid kits in locations accessible to staff but inaccessible to children:
· The isolation is located in the front office for any child who becomes ill during the day.
· LPA observed working carbon monoxide detectors and smoke detectors
· The center has a working telephone
· Sign-in and out procedure -----
· The licensee shall conduct a wellness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ARK ACADEMY
FACILITY NUMBER: 197750150
VISIT DATE: 12/01/2022
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OUTDOOR

The play yard is surrounded by wrought iron fencing. Staff will bring drinking water out for children. There are no bodies of water on the premises. LPA observed very minimum outside play equipment

RESTROOMS

There are 2 bathrooms and a separate staff bathroom.

SUPERVISION:

No child(ren) shall be left without the supervision of a teacher at any time, Supervision shall include visual observation.

CHILDREN’S RECORDS:


All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. LPA gave applicant form LIC 311 to reference
INFANTS:
Applicant was informed of new Safe Sleep Regulations (101439.1 Infant Care Center Sleeping Equipment and the requirement to check on Infants every 15 minutes including documentation.
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
Date, Infant’s name, Time of each 15-minute check, and
the Initials of staff person who conducted each check.

Infants up to 12 months of age should have a completed Individual Infant Sleeping Plan (LIC 9227), a copy must be maintained and kept in the infant’s file and updated as needed.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ARK ACADEMY
FACILITY NUMBER: 197750150
VISIT DATE: 12/01/2022
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HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children.

A refrigerator shall be used to store any medication that requires refrigeration.

Licensee has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 SERVICES

· Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food-preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies.


· Food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin.
· Trashcans, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.
· There is a refrigerator available to store any medication that requires refrigeration.
· All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption. Food in damaged containers shall not be accepted, used or retained.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ARK ACADEMY
FACILITY NUMBER: 197750150
VISIT DATE: 12/01/2022
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POSTINGS:

The licensee shall post signs at the entrance to the child care center that provide the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5

Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.

Applicant is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Community Care Licensing within the time frame specified by the regulation and on the form LIC 624B.



Measurements were as follows:
Indoors: 14 X 20 = 280/35 = 8
Outdoors: 43 X 33 = 1419/75 = 19
LPA observed a changing table in arms reach of a sink

Fire Clearance has been approved for 6 infants.

LPA provided consultation on the following:

Inspection Authority

CCL Website- Provider Information Notices

Personnel Records (form LIC 311A)

Needed Prior to Licensure:

NOIA letter was reviewed during this inspection.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ARK ACADEMY
FACILITY NUMBER: 197750150
VISIT DATE: 12/01/2022
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There is no outdoor shade available

LPA observed peeling paint on the walls in the Preschool room, the walls need sanding and painting

Need a larger fire extinguisher, the fire extinguisher present today is a size 1A10BC and should be a size 2A10BC

The outside play yard consist of black top only, there needs to be some type of cushioning material to brace a fall and minimize injuries to children, also missing sufficient play equipment

LIC 308 needed for Africa Jones

Boarders needed along the bottom portion of the wall in the Blue Room, LPA observed chipping and peeling paint

Applicant must ensure to put the license number on all advertisements.

As a result of this inspection, Applicant states she will put the Infant license on hold for now until she is able to purchase emergency evacuation cribs and outdoor play equipment for Infants (LPA informed applicant she has 90 days) and concentrate on the PS and possibly a SA components. Applicant is also requesting to transfer fees submitted for the Infant Component to a School age component.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
LIC809 (FAS) - (06/04)
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