<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750092
Report Date: 03/02/2022
Date Signed: 03/02/2022 04:22:09 PM

Document Has Been Signed on 03/02/2022 04:22 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GUIDEPOST MONTESSORI AT PLUM CANYONFACILITY NUMBER:
197750092
ADMINISTRATOR:AARON BAILEYFACILITY TYPE:
850
ADDRESS:19141 SKYLINE RANCH RDTELEPHONE:
(949) 354-2259
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 54DATE:
03/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Gina Castello, Head of SchoolTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On March 2, 2022, Licensing Program Analysts (LPAs) Monique Ayala and Isabel Ortega conducted a case management inspection to follow up on an Unusual Incident reported to the department by telephone on 02/25/2022; this incident was reported timely. LPAs were greeted by head of school who guided LPAs on a tour of the facility. Upon arrival, there were 54 children and 9 staff present today.

Description of the incident: On 02/24/2022, child 2 used her water bottle (Hydroflask) to hit child 1 on the forehead. Staff 1 noticed C1 was hit but did not know what caused the incident between C1 and C2. S1 placed an ice pack on C1's forehead and wrote incident reports for both children. The center also notified C1 and C2's parents of the incident.

During this inspection, LPAs interviewed staff, parent of C1, children, obtained pictures of where the incident occurred, obtained a copy of the facility roster and staff files.

Per assistant head of school, on the day of the incident there were 19 children present with 3 staff. Facility was in ratio compliance during the time of the incident.

The information obtained during interviews conducted revealed that S1, S2 and S3 did not observe the incident. S2 was in close proximity, but due to the hill in the middle of yard there was a visual obstruction for S2 to have a visual on C1 and C2 when the incident occurred. LPAs observed the play yard and informed head of school that the big hill in the middle of the yard is a visual obstruction to sufficiently supervise the children in care.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2022
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 3
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: GUIDEPOST MONTESSORI AT PLUM CANYON
FACILITY NUMBER: 197750092
VISIT DATE: 03/02/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The facility is being cited a Type B deficiency according to Title 22 Regulation 101229(a)(1).

An exit interview was conducted, a copy of this report along with appeal right and Notice of Site visit was provided to Head of School.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/02/2022 04:22 PM - It Cannot Be Edited


Created By: Monique Jessica Ayala On 03/02/2022 at 03:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GUIDEPOST MONTESSORI AT PLUM CANYON
FACILITY NUMBER: 197750092

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2022
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision: The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1).
1
2
3
4
5
6
7
Head of school will have a training witl staff on safety and supervision 03/10/2022. Head of school will provide LPA with a sign in sheet of staff that attended.
8
9
10
11
12
13
14
 Supervision shall include visual observation. This requirement was not met as evidence by: Based on interviews and observations conducted staff disclosed that there was no visual on C1 and C2 when the incident occurred. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2022


LIC809 (FAS) - (06/04)
Page: 3 of 3