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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817412
Report Date: 03/28/2022
Date Signed: 03/28/2022 07:19:39 PM

Document Has Been Signed on 03/28/2022 07:19 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:FUNDAMENTALS PRESCHOOL ACADEMY, THEFACILITY NUMBER:
364817412
ADMINISTRATOR:EVELYN CHINCHILLAFACILITY TYPE:
850
ADDRESS:2424 KENDALL DRIVETELEPHONE:
9098871150
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 14DATE:
03/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:EVELYN CHINCHILLATIME COMPLETED:
03:43 PM
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Licensing Program Analyst (LPA) Maddox met with Director, EVELYN CHINCHILLA today for the purpose of conducting an unannounced Annual/Random inspection. LPA toured and inspected all areas according to the facility sketch (3 PS classrooms, 3 bathrooms, and outside play area). There's also a licensed School-age Component (364840755), and an Infant component (364841490) located in a separate building. The hours of operation are MONDAY - FRIDAY 7:00 AM - 6:00 pm
**LPA noted age appropriate furniture, equipment, toys and materials. Classroom was observed to be clean, safe and free of any Health or Safety hazards. Telephone service was verified as well as adequate heating, lighting, and ventilation. Children's belongings are kept in cubbies along the wall as you enter classrooms and labeled with each child's name. Bedding and linens are stored in individual plastic bags to ensure no bedding or linens encounter other bedding or linens from other children (also stored in cubbies labeled with each child's name). Drinking water is available inside the classroom in the form of water coolers.
**There's one bathroom in Pre-K room and 2 additional bathrooms in the office/hallway area (each bathroom has 1T and 1S).

The staff restroom is also located in the office/hallway area. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper and paper towels readily available. Toilets and sinks are functioning properly and age appropriate.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2022
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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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: FUNDAMENTALS PRESCHOOL ACADEMY, THE
FACILITY NUMBER: 364817412
VISIT DATE: 03/28/2022
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**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material and there is adequate shade available. Large play equipment and structures are securely anchored. The area was observed to be free of debris.

**LPA observed working smoke detectors, fire extinguishers, and carbon monoxide detectors throughout center. There is a log of emergency fire/disaster drills; sign in and out sheets contain full legal signatures; License is posted along with other forms that require posting after licensure. Names recorded of Staff and children files reviewed during this inspection. Staff present have current CPR and First Aide training (exp 2/2024); fingerprint clearances, emergency contact information; copies of transcripts with required ECE units.

**Center provides full lunches (enrolled with Food Program). Food preparation area/Kitchen was inspected for safety, cleanliness, proper equipment & protection against contamination and storage, menus observed and posted.


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 - Director states there are no children present whom require IMS, but there is a plan in place.

Exit interview conducted, copy of report left with Director. After conducting a file review for children and staff, some staff and children files missing current Physicals and Immunization's, some staff files missing Mandated Reporter Training. Type B citation issued today.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022
LIC809 (FAS) - (06/04)
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