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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417975
Report Date: 07/07/2023
Date Signed: 07/07/2023 03:22:28 PM

Document Has Been Signed on 07/07/2023 03:22 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:GUARDIAN ANGEL ACADEMYFACILITY NUMBER:
197417975
ADMINISTRATOR:FERGUSON, DIANE HAZELFACILITY TYPE:
850
ADDRESS:13413 BRADLEY AVENUETELEPHONE:
(818) 362-2526
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 5DATE:
07/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Licensee Diane FergusonTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Andrew Alemoh conducted an unannounced annual random site inspection. LPA met with licensee , Diana Ferguson. LPA inspected the inside and outside of the facility.

A total of 5 children and 1 teacher and 2 helpers were present during the inspection. During the inspection children were learning in the prek/kindergarten rm as well as napping on mats.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual cubbies. The facility uses the licensee office or the another classroom to isolate sick children. Age appropriate sinks and toilets were inspected for availability and good repair. Toilet paper, paper towels were observed inside the restroom. First Aid supplies, smoke detectors, carbon monoxide and fire extinguishers were observed. Trash cans with tight lids were observed. A turtle was observed to be in its cage .

The facility does have a pool that is gated all around and is not accessible for children there is another door that divides the play yard from the pool.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023
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: GUARDIAN ANGEL ACADEMY
FACILITY NUMBER: 197417975
VISIT DATE: 07/07/2023
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LPA did observe a menu posted and a water jug inside the classroom.

There is a swimming pool and a spa in the backyard. The bodies of water are completely enclosed by a 5 ft iron fence. The fence runs all the way down to the concrete on which it sits, leaving no room between the bottom of the fence and the concrete. The pool gate was tested and observed to be self-closing and self-latching. The gate has an installed mechanism containing a key to lock the gate and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. All items rendering the fence climbable are moved away from the fence. The mesh fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. LPA took photos to document in the file.


The outdoor playground was inspected and was observed to be free of hazards, loose and sharp parts. LPA observed a turf grass for soft landings and trees that provide shade. All play equipment was in good repair and age appropriate.

Per licensee she currently does not have any medications on the premises. 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: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GUARDIAN ANGEL ACADEMY
FACILITY NUMBER: 197417975
VISIT DATE: 07/07/2023
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The following forms were observed to be posted. The facility license, Parent's Rights Poster (PUB 393), Personal Rights (LIC 613A), Emergency Disaster Plan (LIC 610), Child Car Seat Law (PUB 269).

For additional information and forms visit our website at: www.ccld.ca.gov
A copy of this report must be made available to the public for 3 years.
Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/07/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4