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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750079
Report Date: 09/19/2024
Date Signed: 10/10/2024 04:36:33 PM

Document Has Been Signed on 10/10/2024 04:36 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:APPLE VALLEY CHRISTIAN ACADEMYFACILITY NUMBER:
367750079
ADMINISTRATOR/
DIRECTOR:		TAYLOR ALLENFACILITY TYPE:
860
ADDRESS:22434 NISQUALLY RD.TELEPHONE:
(760) 475-0184
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY: 43TOTAL ENROLLED CHILDREN: 43CENSUS: 0DATE:
09/19/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:19 AM
MET WITH:Taylor Allen, ApplicantTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA's) Maddox and Braddock met with Taylor Allen, Applicant for the purpose of conducting an announced pre-licensing case management inspection. Applicant is requesting licensure of a preschool (23) and school-age (20) components. The center is located within the "Redeemer Church". The hours of operation will be: Mon through Friday from 6:30am - 5:30pm.

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 (carpet).
· 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.
· Drinking water is readily available - thermos and bottled water
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: APPLE VALLEY CHRISTIAN ACADEMY
FACILITY NUMBER: 367750079
VISIT DATE: 09/19/2024
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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
(locked child proof cabinets).
· There are fully stocked first-aid kit(s) in locations accessible to staff but inaccessible to children:
· 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, fully charged fire extinguishers located throughout the center.
· The center has a working telephone
· Sign-in and out procedure - manual
· Staff 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.
OUTDOOR

LPA's observed a shaded rest area for the children (Natural shade from 1 tree, and pop-up umbrellas). Children have safe access to the play yard; the play yard is enclosed by a fence to protect children and to keep them in the outdoor activity area (chain link fencing at least 4 ft high).

There are no bodies of water present.

POSTINGS:

LPA's observed the required forms posted on the Parent Board located in the hallway.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: APPLE VALLEY CHRISTIAN ACADEMY
FACILITY NUMBER: 367750079
VISIT DATE: 09/19/2024
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RESTROOMS

There are 2 separate bathrooms available. All toilets and hand washing facilities were maintained. safe, and sanitary operating condition.

Staff bathroom will also be used as an isolation bathroom.

Measurements taken were as follows:


Room #1
209/35 = 6
Room #2
393/35 = 11
Room#3
245/35 = 7
Bathroom
4 toilets and 4 sinks

Outside play space:


8195/75 = 109

Applicant 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.


SUPERVISION:

Applicant shall ensure no child is left without the supervision of a teacher at any time, Supervision shall include visual observation.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: APPLE VALLEY CHRISTIAN ACADEMY
FACILITY NUMBER: 367750079
VISIT DATE: 09/19/2024
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NAPPING

· Mats used for napping were maintained in a safe condition.


· Each mat shall be equipped with a sheet to cover the cot or mat and, depending on the weather, a sheet and/or blanket to cover the child.
· Mats should be wiped with a detergent/disinfectant weekly or when soiled or wet.
· Bedding will be stored individually so that each child's bedding is identifiable and no child's used bedding comes into contact with other bedding (individual cubbies).
· Napping equipment shall be arranged so that each child has access to a walkway without having to walk on or over the cots or mats of other children.
LEAD TESTING -

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP)

Fire Clearance has been received for the requested capacity of 43 however, with measurements taken, center can accommodate a total of 24 children. Applicant is requesting to have school-age children in 2 & 3 from 6:30am - 7:45 am; preschool children will utilize the classrooms from 7:45 am - 12 noon; School-age children will return at approximately 2:45 pm to closing (5:30 pm). Applicant states she usually has 18 PS children present until 12 noon; after 12 noon, she states she has approximately 6 preschool children left until 5:30; after 12 noon, the preschool children will occupy Room #1 only and School-age children will occupy Rooms 2 & 3 only. An exit interview was conducted, copy of this report left with applicant. Final license determination will be made upon review of the Licensing Program Manager.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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