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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364812085
Report Date: 09/21/2023
Date Signed: 09/21/2023 01:36:07 PM

Document Has Been Signed on 09/21/2023 01:36 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:SJUSD-PINON HILLS ELEMENTARY SCH. STATE PRESCHOOLFACILITY NUMBER:
364812085
ADMINISTRATOR:KIMBERLY MARTINFACILITY TYPE:
850
ADDRESS:878 MONO ROADTELEPHONE:
(760) 792-8097
CITY:PINON HILLSSTATE: CAZIP CODE:
92372
CAPACITY: 24TOTAL ENROLLED CHILDREN: 20CENSUS: 18DATE:
09/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Cortes DanielleTIME COMPLETED:
02:00 PM
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On 09/2/12023, Licensing Program Analyst (LPA) Carol Heath met with the PM Lead Teacher, Cortes Danielle, to conduct an unannounced Annual/Random inspection. LPA disclosed the purpose of the inspection and was granted entry to the facility. Upon arrival, LPA observed 1 classroom in use with a total of 15 children and 1 teacher and 2 aids on the premises. The hours of operation are 8:15 AM – 11:15 AM and 12:00 PM – 3:00 PM, Monday - Friday. The center is located at Pinon Hills Elementary School. Incidental Medical Services (IMS) were discussed.
Physical Plant: LPA toured and inspected the preschool classrooms. Furniture and equipment were checked for age appropriateness and good repair. All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children's belongings labeled with their names. LPA observed age-appropriate toys and materials. Daily activities schedule was observed in each classroom. This is half-day program. No napping equipment is needed it. Drinking water is available inside the classrooms in the form of disposable plastic cups and water jugs. A fire extinguisher (checked 6/26/2023), a smoke detector, and a carbon monoxide detector are on the premises.
All containers used for storage of solid wastes, including moveable bins, shall have a tight fitting cover that is kept on; they shall be leakproof and rodent-proof.
LPA inspected and observed 1 clean bathroom. LPA noted all toilets and sinks were sanitary and operational. The toilets and sinks function properly and are age appropriate.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SJUSD-PINON HILLS ELEMENTARY SCH. STATE PRESCHOOL
FACILITY NUMBER: 364812085
VISIT DATE: 09/21/2023
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The water temperature inside the classroom is too hot. LPA ran the water, and the temperature is hot. LPA asked for the thermometer and the water temperature is 120 degrees. The school was able to remove the hot water faucet on both classroom sinks. LPA observed soap, toilet paper, and paper towels readily available.
Children are inspected for illnesses as they arrive with an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission.The Director and other administration staff administer medication and document the dosage, date, and time on a log. Medication is brought and locked at the center (unless the parent requests daily return). Medication is labeled correctly and stored in its original container. Medication is kept at the center until expiration and sent home with the parent for disposal. There are currently no children in care with IMS needs. The teacher working area is for isolating and caring for ill children. There is a mat available for ill children. An isolated toilet and sink are available for ill children in the staff restroom.
A Fire Drill/Earthquake log is posted in the office. The center conducted disaster drills for at least 6 months (9/1/2023). A current Roster is available.
Lead Testing: According to the director, the center had drinking water tested for lead contamination levels on 02,2023. Based on the records reviewed, outlet (E) in the classroom Bottle Fill-up Station drinking fountain has an ALE of 6.44 ppb. The case management visit was conducted on 1/13/2023.
The outdoor: The play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The play area has a playground cushion and concrete. The play area was inspected and found to be free of hazards and inaccessibility to bodies of water. Preschool has a separate playground yard for school-age. There is a bike path, basketball hoop, and other age-appropriate toys. LPA observed a first aid kit. LPA provided a First aid supplies list to the Director.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SJUSD-PINON HILLS ELEMENTARY SCH. STATE PRESCHOOL
FACILITY NUMBER: 364812085
VISIT DATE: 09/21/2023
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The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Sign-in and out sheets were reviewed. The Teacher-to-child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if the children’s basic needs were met and appropriate.
Staff Records/ Children Records: Staff and Children's records were reviewed. LPA verified there is at least 1 staff person present with current CPR and First Aid Training. A staff will need to complete the Mandated Reporter training (every 2 years). All staff receives Measles, Pertussis, and Influenza vaccination. All staff have required fingerprinting associated with the facility.
LPA reviewed 5 children's records, complete with the parent’s signature.
Staffing Ration and Capacity: Upon arrival, LPA observed 1 classroom in use with a total of 15 preschool children and 1 teacher and 2 aids on the premises.
Food Service: All the food is from school cafeteria. The facility provides a PM snack. Allergy lists are posted in the classroom (None at this time). The chemicals are kept separate from the food (locked inaccessible in classroom cabinets). Menus are posted at least one week in advance and made available for review by the parents.
The following general information was discussed during this inspection:
· 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SJUSD-PINON HILLS ELEMENTARY SCH. STATE PRESCHOOL
FACILITY NUMBER: 364812085
VISIT DATE: 09/21/2023
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· As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
· §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
· All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
· Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184
· Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
· Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SJUSD-PINON HILLS ELEMENTARY SCH. STATE PRESCHOOL
FACILITY NUMBER: 364812085
VISIT DATE: 09/21/2023
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· Center Director advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation (call within 24 hours and submit a written report within 7 days) and on the form LIC624. The Center reminded to review updates/regulations and quarterly updates on the Department website. The "Notification of Parent's Rights" poster must be posted in an area of the center accessible to parents. The information regarding new legislation about exemptions and Parent’s Rights was also discussed.

No deficiency was cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

Exit interview conducted and report was reviewed with the Lead Teacher, Cortes Danielle.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
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