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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 147750002
Report Date: 08/18/2022
Date Signed: 08/22/2022 10:19:28 AM

Document Has Been Signed on 08/22/2022 10:19 AM - 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:ICOE- ELM ST STATE PRESCHOOLFACILITY NUMBER:
147750002
ADMINISTRATOR:KATHLEEN DUNCANFACILITY TYPE:
850
ADDRESS:800 W ELM ST BLDG ATELEPHONE:
(760) 873-5123
CITY:BISHOPSTATE: CAZIP CODE:
93514
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 0DATE:
08/18/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:29 AM
MET WITH:Peggy Lindsay, Early Learning Program Coordinator TIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Maddox conducted an announced visit today and met with Peggy Lindsay, Early Learning Program Coordinator for the purpose of conducting a Pre-Licensing inspection for a PS component for children ages 3 - 5 yrs. The hours of operation will be : 7:45 am to 5:15 pm. Applicant are requesting to be licensed for 20 children in Bldg "A". There are 4 separate buildings on the same property, each building has it's own license number. This site is operating under the instruction of RM Herring as they go through the licensing process.

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
· 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 water bottles and tap water with disposable cups.
· 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 upper cabinet in the kitchen area.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: ICOE- ELM ST STATE PRESCHOOL
FACILITY NUMBER: 147750002
VISIT DATE: 08/18/2022
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· There are fully stocked first-aid kits in the kitchen and office areas.
· The isolation is located teachers office for any child who becomes ill during the day.
· LPA observed working dual carbon monoxide, smoke detectors. Fully charged fire extinguishers throughout the facility.
· The center has a working telephone.
· Sign-in and out procedure (manually) and "class dojo".
· The licensee shall conduct a well ness 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 and umbrellas.

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. The outside play area is totally fenced. Drinking Water

· There are no bodies of water on the premises


GRASS AREA: 2,178 + 1,364 = 3542/75 = 47
CEMENT: 32 x 36 = 1,152/75 = 15
SAND AREA: 57 x 25 = 1,425/75 = 19
TOTAL OUTDOOR SPACE: 81
RESTROOMS

There are 2 bathrooms inside the classroom, each has 1 toilet and 1 sink. All toilets, hand washing facilities were maintained in safe and sanitary operating condition.

Staff bathroom is located in Bldg C.

SUPERVISION:

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

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ICOE- ELM ST STATE PRESCHOOL
FACILITY NUMBER: 147750002
VISIT DATE: 08/18/2022
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TRANSPORTATION:

Center will not provide transportation at this time

CHILDREN’S RECORDS and STAFF FILES: File will be kept in locked file cabinets in the teachers office which is also kept locked. All children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours.


NAPPING

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


· Each cot/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. blankets and linens are kept in zip lock bags labeled with children's names.
· LPA informed applicant Cots or mats should be wiped with a detergent/disinfectant weekly or when soiled or wet.
HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children (on top of refrigerator in locked cabinets).

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

The lead teacher will be designated to dispense medication when needed.

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

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ICOE- ELM ST STATE PRESCHOOL
FACILITY NUMBER: 147750002
VISIT DATE: 08/18/2022
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FOOD SERVICES

Free lunch program through Bishop Elementary School District or children can bring their own lunches. Center will provide AM and PM snacks.

· There is a refrigerator available to store any medication that requires refrigeration.


Center has a disaster plan in place and posted in the classroom.

POSTINGS:

Center has a parent board with all the required forms.


Applicant was informed 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.

Measurements were as follows:
8 X 11 = 88/ 35 = 3
31 X 14= 434/35 /35 = 12
8 X 16 = 128/35 = 4
Total Indoor capacity: 22

Staff has taken the Lead Poisoning Training

Fire Clearance has been received for the capacity of 20.



Exit interview conducted, facility will be licensed once fingerprints have been associated.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4