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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750066
Report Date: 07/20/2023
Date Signed: 07/20/2023 12:16:12 PM

Document Has Been Signed on 07/20/2023 12:16 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:SAN GORGONIO INFANT/TODDLER CENTERFACILITY NUMBER:
367750066
ADMINISTRATOR:LATASHIA KELLYFACILITY TYPE:
830
ADDRESS:2299 PACIFIC STREETTELEPHONE:
(909) 880-6706
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 0DATE:
07/20/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Latashia Kelley, DirectorTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Maddox met with Latashia Kelly, Director today for the purpose of conducting an announced Prelicensing inspection. This center is located on the grounds of San Gorgonio High School, in a modular located behind the large parking lot. The Infant Toddler component consist of 1 classrooms, kitchenette, bathrooms, and outside play area. The hours of operation will be: Monday through Friday from 7:00 am -5:30 pm .

INDOOR ACTIVITY SPACE:

· The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors


· Floors of all rooms have a surface that is safe and clean (wood flooring)
· A comfortable temperature for children shall always be maintained.
· Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
· Tables and chairs were present to meet the needs of the children.
· Center will have a water service company for inside and outside drinking water with disposable cups.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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: SAN GORGONIO INFANT/TODDLER CENTER
FACILITY NUMBER: 367750066
VISIT DATE: 07/20/2023
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·Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children (stored in locked cabinet under the sink in the kitchenette area.
· There are fully stocked first-aid kit(s) in locations accessible to staff but inaccessible to children.
  • Cribs are aligned along the back area of the classroom, LPA observed there is space between the cribs and the way the cribs are situated staff will still have direct supervision.
· The isolation area is located in the office for any child who becomes ill during the day.
· LPA observed operable carbon monoxide detectors and smoke detectors(hard wired).
  • Fire extinguishers are located throughout the classroom and fully charged.
· The center has a working telephone
· Sign-in and out procedure will be done by an app called M - Sign technology.
· 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.
  • The indoor activity space for infants is physically separate from space used by toddlers in the child care center.
  • The sleeping area for infants is physically separate from the indoor activity space.
  • LPA observed the following regarding the Infant changing tables: there is a padded surface no less than one-inch thick and covered with washable vinyl or plastic; the sides of the infant table has raised sides at least three inches high; maintained in good repair and safe condition; placed within arm's reach of a sink.
  • All equipment or furniture shall be washed with a detergent/disinfectant after each use
  • The diaper changing table shall be washed and disinfected after each diaper change.
  • Each crib, mat or cot shall be occupied by only one infant at a time.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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: SAN GORGONIO INFANT/TODDLER CENTER
FACILITY NUMBER: 367750066
VISIT DATE: 07/20/2023
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  • Bedding shall be changed daily
  • Cribs shall be free from all loose articles and objects, including blankets and pillows.
  • Pacifiers shall be allowed in the crib if the following provisions are in place: There shall not be anything attached to the pacifier.
  • Bumper pads shall not be used.
  • LPA observed Cribs, mats or cots arranged so as to provide a walkway and permit staff to reach each infant without having to step over or reach over any other infant.
  • LPA explained the following regarding Section 101439.1 Infant Care Center Sleeping Equipment: Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
OUTDOOR

The outside play yard is surrounded by fencing and divided into sections to provide a physical separation for each component. The play yard was free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. There is no high climbing apparatus on the Infant yard. There are no bodies of water on the premises and tarp sails cover the play yard and provide shade. Staff will bring bottles and sippy cups for outside drinking water, there is safe access to the play yard.

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

TRANSPORTATION:

Center will not provide transportation for School age children only.

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

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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: SAN GORGONIO INFANT/TODDLER CENTER
FACILITY NUMBER: 367750066
VISIT DATE: 07/20/2023
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RESTROOMS

Bathrooms are not required for Infants, there is a staff bathroom located within the class- room. Potty chairs will be available for every 5 infants potty training.

SUPERVISION:

Applicant shall ensure no child is left without the supervision of a teacher at any time, Supervision shall include visual observation. In addition, Applicant is aware of the requirement to check on sleeping Infants every 15 minutes and to ensure parents complete form LIC 9227 particularity Infants sleeping habits (i.e. can the infant turn over unassisted)

CHILDREN’S RECORDS:


Applicant is aware of the required forms for children's records. LPA explained all children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours.

HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children (kept in a locked cabinet in the office. A refrigerator is available to store any medication that requires refrigeration.

Applicant 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.

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

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC809 (FAS) - (06/04)
Page: 4 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: SAN GORGONIO INFANT/TODDLER CENTER
FACILITY NUMBER: 367750066
VISIT DATE: 07/20/2023
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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 - Licensee states staff have been trained to provide incidental medical services.

POSTINGS: Licensee is aware of the forms that must be posted after licensure including 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

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 tight fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.
  • Center will provide baby formula and baby food provided by Nutrition Services.

There is a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC809 (FAS) - (06/04)
Page: 5 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: SAN GORGONIO INFANT/TODDLER CENTER
FACILITY NUMBER: 367750066
VISIT DATE: 07/20/2023
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Measurements taken were as follows:

INFANTS
Eating Area:
18 X 13 = 234/35 = 7

Crawlers: 10.5 X 14.3 = 151/35 =5
Walkers: 12 X 12.5 = 156/35 = 5
Toddler Area: 25.2 X 20 = 504/35 = 15
Total Indoor Space: 32

Outside play space:
64 X 69 = 4,416/75 = 59

BATHROOM
There is 1 bathroom located inside the classroom designated for children, there is also a separate staff bathroom inside the classroom that will also be used as an isolation bathroom. LPA also observed a diaper changing table within arms reach of a sink.

Staff shall ensure the grass area is free of any safety hazards prior to children accessing the play yard. Outside play equipment will be stored in a closet located inside the classroom.

Fire clearance has been granted for the requested capacity of 38, however, with measurements taken today, center will be approved for a capacity of 32. Exit interview conducted, copy of this report reviewed by the Director, copy of report left at facility.

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

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC809 (FAS) - (06/04)
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