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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750091
Report Date: 05/24/2022
Date Signed: 05/24/2022 05:28:07 PM

Document Has Been Signed on 05/24/2022 05:28 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GUIDEPOST MONTESSORI AT PLUM CANYONFACILITY NUMBER:
197750091
ADMINISTRATOR:AARON BAILEYFACILITY TYPE:
830
ADDRESS:19141 SKYLINE RANCH RDTELEPHONE:
(949) 354-2259
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 34DATE:
05/24/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:34 PM
MET WITH:Gina Castello, Head of SchoolTIME COMPLETED:
05:30 PM
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On May 24, 2022, Licensing Program Analyst (LPA) Monique Ayala and Licensing Program Manager (LPM) Mariela Ramon conducted a case management inspection to follow up on an Unusual Incidents that occurred on 04/06/2022; these incidents were reported timely. LPA and LPM were greeted by head of school who guided LPAs on a tour of the facility. Upon arrival, there were 34 children and 10 staff present today.

Description of incident: On 04/06/2022 child 1 was riding a pushing a bike down the hill when child tipped to the right and scraped the side of child 1's face on the brick wall. The scrape on Child 1 was about an inch long. An ice pack was provided.

Description of incident: On 04/06/2022, child 2 was walking and got in front of child 3, when child 3 pushed child 2. As a result of the push, child 3 fell and hit their head on the concrete floor. There were no bumps observed, and an ice pack was provided.

At this time further follow up is needed.

An exit interview was conducted and a copy of this report was provided to head of school along with notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2022
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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