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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750178
Report Date: 12/11/2023
Date Signed: 12/14/2023 09:00:41 AM

Document Has Been Signed on 12/14/2023 09:00 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BOUQUET CANYON EARLY LEARNING ACADEMYFACILITY NUMBER:
197750178
ADMINISTRATOR:DIANNA GONZALEZFACILITY TYPE:
850
ADDRESS:28110 WELLSTON DRIVETELEPHONE:
(661) 294-5300
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 96TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/11/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Dianna Gonzalez, DirectorTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Maddox and LPM Deborah Lowe conducted an announced inspection today and met with Dianna Gonzalez, Director for the purpose of conducting a Pre-Licensing inspection. This PS component is located on the grounds of Bouquet Canyon Elementary School, Saugus Union School District. Application received for a capacity of 48. This center will operate 2 half day sessions, the AM session will operate Mon - Fri from 8:30 am to 11:30 AM and the PM session will operate Mon, Tues, and Thurs from 12:30 PM - 2:30 PM. During this inspection, LPA measured 2 modulars (Room's 23, 24, & 25). Center is anticipating opening January 16, 2024.

INDOOR ACTIVITY SPACE:

· The child care center was toured and found to be clean, safe, sanitary, and in good repair to ensure the safety and well-being of children, employees and visitors


· Floors of all rooms have a surface that is safe and clean (tile flooring).
· A comfortable temperature for children shall always be maintained.
· Furniture and equipment are maintained in good condition, free of sharp, lose or pointed parts. There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.
· Tables and chairs were present to meet the needs of the children.
· Drinking water is readily available will be provided via water bottles
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/11/2023
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 12/11/2023
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· 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 locked cabinets). Stored in cabinets outside of the classrooms in locked cabinets inaccessible to children.
· There is a fully stocked first-aid kit(s) located in the school's nurses office.
· The isolation area is located in the school office for any child who becomes ill during the day.
· LPA observed operable carbon monoxide detectors and smoke detectors. Fire extinguishers are located throughout the facility and fully charged.
· The center has a working telephone
· Sign-in and out procedure will be conducted manually.
· The licensee shall conduct a wellness check to ensure that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.

OUTDOOR

LPA observed a large shaded rest area for the children. The play yard was free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. 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 (rubber matting). Outside drinking water will be provided via water bottles. The entire yard is fenced (more than 4 ft). LPA and LPM did not observe any bodies of water on the premises.

RESTROOMS

The bathrooms are located directly outside of the classrooms. There are Boys and Girls bathrooms. All toilets and hand washing facilities were maintained in safe and sanitary operating condition.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 12/11/2023
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The staff bathroom located in the school office and will also be utilized as the isolation bathroom.

SUPERVISION:

Applicant shall ensure no child is left without the supervision of a teacher at any time, Supervision shall include visual observation.

TRANSPORTATION:

Any transportation provided will be provided by the School District.

CHILDREN’S RECORDS:


Director is aware of the required forms that are required for children's files. LPA explained all children's records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours.

NAPPING

This center only operates half day sessions so children will not nap.


HEALTH RELATED SERVICES:

Medications shall be kept locked in the nurses office, medications must be in the original packaging. A refrigerator shall be used to store any medication that requires refrigeration. Applicant 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.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 12/11/2023
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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. IMS plan in place.

FOOD SERVICES

There is a snack menu must be posted for parents’ review. Snacks will be delivered daily from the school district.

LPA advised applicant that the trash cans, including moveable bins, shall have a tight fitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

POSTINGS:

Applicant was informed 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

Director has implemented a disaster and mass casualty plan of action. The plan is in writing and 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.



Indoor measurements contain a total of 2491.19 square feet which will accommodate applicants requested capacity.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 12/11/2023
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Outside measurements contain a total of 4675.91 square feet which will accommodate applicants requested capacity.

Bathrooms will accommodate the requested capacity.

A Fire Clearance has been received for the requested capacity of 48 children.

Needed prior to licensure: Pending review of additional documents received during this inspection.

An exit interview was conducted with the above items discussed and a copy of this report was provided to the Applicant, Dianna Gonzlez. Final license determination will be made upon review of the Licensing Program Manager.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC809 (FAS) - (06/04)
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