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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750162
Report Date: 05/25/2023
Date Signed: 06/13/2023 09:23:58 AM

Document Has Been Signed on 06/13/2023 09:23 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:ACADEMY OF EXCELLENCEFACILITY NUMBER:
197750162
ADMINISTRATOR:BEVERLY MOODYFACILITY TYPE:
830
ADDRESS:1324 WEST AVENUE J SUITE 5TELEPHONE:
(661) 206-9344
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/25/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:03 PM
MET WITH: Applicant Chauncey SmithTIME COMPLETED:
01:43 PM
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Licensing Program Analyst (LPA) Maddox met with Applicant Chauncey Smith today for the purpose of conducting a pre-Licensing inspection. Applicant is requesting a capacity of 30 School-age (SA) children ages 6 - 12 yrs. Applicant has also submitted applications for an SA (X 197750163) and PS Component (X 197750161). This will be Applicants second location, the first location is located at 725 E AVENUE J, Lancaster, CA 93535. During this inspection, LPA measured 1 classroom, 2 bathrooms, and the outside play area designated for SA children. The hours of operation will be: Mon through Saturday from 6:30 am 11:00 pm. This center is located in the rear of a strip mall
INDOOR ACTIVITY SPACE:
  • Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate age-appropriate washable toys and equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
  • 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 the office and kitchen area, both are off limits to children).
  • The isolation is located in the office for any child who becomes ill during the day.
  • LPA observed operable carbon monoxide detectors and smoke detectors(hard wired). Fire extinguishers are located throughout the facility and fully charged.
  • The center has a working telephone
  • There is a Sign-in and out procedure in place - manually
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/25/2023
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: ACADEMY OF EXCELLENCE
FACILITY NUMBER: 197750162
VISIT DATE: 05/25/2023
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  • The licensee shall conduct a wellness check to ensure infants with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
  • The indoor activity space for infants is physically separate from space used by children in the child care center and school-age child care center components.
  • The sleeping area for infants is physically separate from the indoor activity space.
  • LPA observed the following regarding the Infant changing tables: there is a padded surface no less than one-inch thick and covered with washable vinyl or plastic; the sides of the infant table has raised sides at least three inches high; maintained in good repair and safe condition; placed within arm's reach of a sink.
  • All such equipment or furniture shall be washed with a detergent/disinfectant after each use
  • The diaper changing table shall be washed and disinfected after each diaper change.
  • Each crib, mat or cot shall be occupied by only one infant at a time.
  • Bedding shall be changed daily
  • Cribs shall be free from all loose articles and objects, including blankets and pillows.
  • Pacifiers shall be allowed in the crib if the following provisions are in place: There shall not be anything attached to the pacifier.
  • Bumper pads shall not be used.
  • LPA observed Cribs, mats or cots arranged so as to provide a walkway and permit staff to reach each infant without having to step over or reach over any other infant.
  • LPA explained the following regarding Section 101439.1 Infant Care Center Sleeping Equipment: Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
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: ACADEMY OF EXCELLENCE
FACILITY NUMBER: 197750162
VISIT DATE: 05/25/2023
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  • In addition, Mattresses shall be made specifically for the size crib in which they are placed. Wiped with a detergent/disinfectant daily and when soiled or wet. Maintained in a safe condition with no exposed foam, batting or coils.
  • Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.
(b) The needs and services plan shall be in writing and shall be in compliance with Title 22; Section 101419.2 including the following: Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)]. which is incorporated by reference.
The needs and services plan shall be maintained in the infant’s file and shall be available to the Department for review.

OUTDOOR

LPA observed a shaded rest area for the children.


As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls (wood chips).
LPA observed age appropriate play equipment
Drinking Water will be available via bottles and sippy cups.
The entire yard is fenced and the Infant yard is physically separate from the PS/SA play yard. There are no bodies of water on the premises
RESTROOMS

There is no physical bathroom designated for infants (not required), however, LPA observed a changing table within arms reach of a sink. There are potty chairs available (1 potty chair for every 5 Toddlers potty training), bathrooms available for disposal. All toilets and hand washing facilities shall be maintained in safe and sanitary operating condition.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
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: ACADEMY OF EXCELLENCE
FACILITY NUMBER: 197750162
VISIT DATE: 05/25/2023
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Staff bathroom- there is a staff bathroom located in the entrance area, this bathroom is also designated as an isolation bathroom.

SUPERVISION:

Applicant/Licensee shall ensure no infant is left without the supervision of a teacher at any time, Supervision shall include visual observation. In addition, Applicant/Licensee shall check on sleeping infant (including documenting) every 15 minutes.

TRANSPORTATION:

Center will not provide transportation for Infants.

CHILDREN’S RECORDS:


Applicant/Licensee is aware of the required forms that should be available for each child in care. LPA explained all children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours.
HEALTH RELATED SERVICES:

Medications shall be kept in a safe place inaccessible to children.


A refrigerator is available to store any medication that requires refrigeration.
Applicant/Licensee has implemented a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.
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: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
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: ACADEMY OF EXCELLENCE
FACILITY NUMBER: 197750162
VISIT DATE: 05/25/2023
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FOOD SERVICES

There shall be an individual feeding plan for each infant. The plan shall be completed and available for use prior to the infant's first day at the center and shall be accordance with Title 22, Section 101427 - Infant Care Food Service



POSTINGS:

The Applicant/Licensee are aware of the required forms that shall be posted after licensure including the telephone number of the local health department and information on child passenger restraint systems pursuant to Health and Safety Code section 1596.95(g) and Vehicle Code sections 27360 and 27360.5

  • Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.
  • Applicant 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.


Needed Prior to Licensure: During this inspection, the center was not fully set up to receive children. The child care center shall be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors. LPA will accept pictures of the indoors and outdoors once set up AND before accepting children

Exit interview conducted, copy of this report was read and signed by Director, a copy of this report was left at the conclusion of this inspection.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
LIC809 (FAS) - (06/04)
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