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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412816
Report Date: 10/11/2023
Date Signed: 10/11/2023 05:37:40 PM

Document Has Been Signed on 10/11/2023 05:37 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:DEVONSHIRE MONTESSORI SCHOOLFACILITY NUMBER:
197412816
ADMINISTRATOR:SAGADEVAN, ROMANYFACILITY TYPE:
850
ADDRESS:14941 DEVONSHIRE STREETTELEPHONE:
(818) 361-4715
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY: 72TOTAL ENROLLED CHILDREN: 52CENSUS: 21DATE:
10/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Naresh Moon, Licensee and Silvia Ponce, Lead TeacherTIME COMPLETED:
05:37 PM
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On 10/11/2023 Licensing Program Analyst (LPA), Isabel Ortega met with Facility Licensee Naresh Moon Lead and Teacher Silvia Ponce and conducted an Annual Random inspection. LPA toured and inspected the facility in accordance with the facility sketch. During inspection LPA observed 21 children in care and four staff providing care and supervision. Facility operates in five classrooms.

An isolation area was inspected, which takes place in the main office. Children have the option for rest time and quiet time if needed. Children are provided with mats for rest time when needed. Age-appropriate sinks and toilets were inspected for availability and good repair. Toilets flush properly; Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, restocked of toiletries by staff and on-site custodian disinfects, and sanitizes daily.

There is a total of five classroom currently being utilized for childcare. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and AC ventilation were evaluated. LPA observed individual storage with children’s for children's belongings. Facility sampled water for lead on 7/15/2023 and results were provided on 7/18/2023.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: DEVONSHIRE MONTESSORI SCHOOL
FACILITY NUMBER: 197412816
VISIT DATE: 10/11/2023
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Results are under the 5.5 ppb which is the maximum allowable. The classroom consists of filtered water in a water jug container for indoor and outdoor drinking water. Children bring their own water bottles from home; facility also has individual disposable cups available.

Facility operates full time and part time care Monday through Friday from 7:00 a.m. to 6:00 p.m. Facility provides morning and afternoon snack for children enrolled. Children bring their own lunch daily.

Facility has all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, and Earthquake Preparedness Checklist.

First Aid supplies, smoke detectors, carbon monoxide (tested 4:05 p.m.) are observed to be operating properly. The fire extinguisher (2A10BC) is reading in green (last serviced on 9/25/2023) and meets the Fire Marshal codes and standards.

Trash cans with tight lids were observed. Food was inspected, and it was properly labeled, stored, and within expiration date. Refrigerator is clean and operating at the proper temperature. A refrigerator is adequately equipped, clean, and free from hazards. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 8/16/2023 at 10:30 a.m. Food allergies are noted and are posted in the food preparation area and in each classroom.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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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: DEVONSHIRE MONTESSORI SCHOOL
FACILITY NUMBER: 197412816
VISIT DATE: 10/11/2023
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The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair, and age appropriateness. During outdoor play children are provided with filtered water in a water jug container (disposable cups are available). There is adequate shade area for rest. The playground is well fenced all around, and no bodies of water observed in the outdoor play area.

The parent board was reviewed and has all the required forms. The snack menu is posted accessible and visible to parents.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are all in the children's file. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

Directors and teachers are currently certified in Pediatric CPR/First Aid which expires until 02/09/2025. Child Care Provider Mandated Reporter (AB1207) training is dated 06/11/2023.

The following Incidental Medical Services (IMS) were discussed.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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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: DEVONSHIRE MONTESSORI SCHOOL
FACILITY NUMBER: 197412816
VISIT DATE: 10/11/2023
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For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

All staff are required to take the Child Care Provider Mandated Reporter (AB1207) training every 2 years. www.mandatedreporterca.com.

Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. Director is aware self and all staff are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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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: DEVONSHIRE MONTESSORI SCHOOL
FACILITY NUMBER: 197412816
VISIT DATE: 10/11/2023
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For additional information and forms visit our website at: www.cdss.ca.gov

For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

Per Title 22 Regulations facility is complying with rules and regulation, no deficiency will be issued today. An exit Interview was conducted with Lead Teacher Silvia Ponce. A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day.

A copy of this report must be made available to the public for 3 years.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
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