364808414-1-11-2024-12-CC-BIBE-CZDS7Y-20240111123819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364808414
Report Date: 01/11/2024
Date Signed: 01/11/2024 12:38:35 PM

Document Has Been Signed on 01/11/2024 12:38 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:	CAJON HIGH SCHOOL		FACILITY NUMBER:	364808414
ADMINISTRATOR:	LATASHIA L KELLY		FACILITY TYPE:	830
ADDRESS:	1200 W. HILL DRIVE		TELEPHONE:	(909) 388-6307
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92407
CAPACITY: 38	TOTAL ENROLLED CHILDREN: 38	CENSUS: 15	DATE:	01/11/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	MARY COE		TIME COMPLETED:	12:55 PM

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Licensing Program Analyst (LPA) Babatunde Ibitoye met with Infant Teacher, Ms Mary Coe today for the purpose of conducting an Required unannounced Annual inspection. Present today were 3 Infants (3 Staff) and 12 Toddlers (5 Staff). This Infant/Toddler program is held on the grounds of Cajon High School in Infant/Toddler Portable #2. Portable is divided into 2 sides (Infants and Toddlers), center maintains a physical separation. Cribs are kept in a separate area where teachers can still main visual observation. LPA toured the portable modular which consist of 2 bathrooms; main area; kitchenette; and Staff Bathroom. The hours of operation: MONDAY THROUGH FRIDAY 7:00AM TO 5:30PM.

Indoor/Children’s Area: Child care center is clean, safe, sanitary, and in good repair; all indoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are kept free of obstruction; floors of the classroom has a surface that is safe and clean, cleaning compounds inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has individual permanent storage space ( individually labeled with name) for his/her clothing and personal belongings. Classrooms were observed to be clean, safe and free of any Health or Safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Drinking water is available inside the classroom in the form of water coolers, children have their own individual cups.

**The children's bathrooms were inspected; each bathroom has 1 toilet and 1 sink. The staff rest-room is located next to the rear entrance. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate. Changing tables are located within arms reach of a sink.

LPA observed sleep logs depicting 15 min checks, Needs and Service Plans; and Fire Emergency Disaster log

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: CAJON HIGH SCHOOL	FACILITY NUMBER: 364808414
	VISIT DATE: 01/11/2024

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*Food preparation area/Kitchenette was inspected for safety, cleanliness, proper equipment & protection against contamination and storage. Center serves breakfast and lunch, food provided by school cafeteria, menus observed and posted. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children. The refrigerator was inspected, LPA observed bottles and Sippy cups labeled with children's names. Allergy List is posted

**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations. At least 1 staff person present with current Pediatric CPR and First Aid (exp 8/9/2025). LPA reviewed a sampling of children files today as part of this inspection. Children's files contain Needs and Service Plans and current immunization's, Sign in and out sheets were inspected(Care connect App) and contain full legal signatures. LPA observed a fully stocked first aid kit; fully charged fire extinguishers; carbon monoxide detectors throughout the center. Fire Drill/Earthquake log is posted (10/3/2023). Staff files are kept at the San Bernardino District office,staff are fingerprinted through the San Bernardino School District. Teaching Credentials provided for Ms Coe.

**Center has stackable cots individually stored so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding. Each cot is equipped with a sheet to cover the cot and labeled with each child's name. Bedding and linens are laundered daily and as needed. All flooring and carpets were inspected for cleanliness, and in good repair.

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material, there are trees on the grass area. The area was observed to be free of debris. Drinking water is brought outside for children. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area. There is a locked storage shed on the yard that contains children's play equipment and supplies.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: CAJON HIGH SCHOOL	FACILITY NUMBER: 364808414
	VISIT DATE: 01/11/2024

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Teacher advised of the requirement to report Unusual Incidents. Teacher was 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 the daycare center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8 am-5 pm.

Health-Related Services: Teacher has been advised all prescription and non-prescription medications must have the child’s name and are dated, written consent and instruction from the child’s representative, and a plan to document and report to the child’s representative when medication is administered to a child; Medication will be properly labeled and stored in its original container.

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 -

*Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The director shall permit the Department to inspect the family child care home 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.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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: CAJON HIGH SCHOOL	FACILITY NUMBER: 364808414
	VISIT DATE: 01/11/2024

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A survey will be sent to the email address provided to improve the quality and value of the new inspection process. 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

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. No deficiency was cited today.

An exit interview was conducted and the report was reviewed with the Infant Teacher Mary Coe

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

LIC809 (FAS) - (06/04)

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