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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818021
Report Date: 08/24/2021
Date Signed: 08/24/2021 12:20:24 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/24/2021 12:20 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:BALDY MESA STATE PRESCHOOLFACILITY NUMBER:
364818021
ADMINISTRATOR:KIMBERLY MARTINFACILITY TYPE:
850
ADDRESS:10376 BALDY MESA ROADTELEPHONE:
(760) 868-6229
CITY:PHELANSTATE: CAZIP CODE:
92329
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 27DATE:
08/24/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Andrea StiegelmarTIME COMPLETED:
12:30 PM
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On 8/24/2021, Licensing Program Analyst (LPA) Carol Heath met with Lead Teacher, Daisy and Corene for the purpose of conducting an unannounced Annual/Random inspection. During this inspection, the Director, Andrea Stiegelmar arrived. The remainder of this inspection was conducted with the Director. This State Preschool occupies Rm's #1 and 2. Rm #1 had 2 staff (1 teacher, 1 sub, and 1 TA with 13 children) and Rm #2 had 2 staff (1 teacher and 1 TA's 14 children). This State Preschool is held on the site of Baldy Mesa Elementary School in Phelan, the hours of operation are Mon - Fri from 8:15 AM -11:15. This preschool is closed for the summer from June 11 to August 11 . There is a waiver on file for the Pre-school children to share the bathroom and play yard, there is a staggered play yard schedule.

**LPA observed age appropriate furniture, equipment, toys and materials. The classrooms were observed to be clean and 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. Drinking water is available inside the classroom in the form of a water fountains.
**The children's bathroom is located in the main entrance area. The bathroom has 2 toilets and 2 sinks. The staff restroom is located next door to the office. 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.

**Kitchen: No kitchen in this facility.

Cleaning solutions are stored separately away from the classrooms. ( locked cabinet and office).

**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes sand and wood chips and artificial turf under climbing structures for cushioning material and there is enough and adequate shade available. Large play equipment and climbing structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available in the form of a water fountain (it is closed during the COVID-19). Sandboxes are raked and inspected daily and kept free of hazardous foreign materials. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area.

**This school serves snacks only which are delivered from the cafeteria. Menus observed and posted. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children



**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid (exp 10/2022), **The Parent Board located within the classrooms has contains required licensing forms.

Sign in and out sheets: Both classrooms used electric signature. were inspected and contain full legal signatures. LPA observed a fully stocked first aid kit (in the front door); fully charged fire extinguishers (7/2021); and carbon monoxide detectors (with school ).

Children's and staff records were reviewed.



· The following general information was discussed during this inspection:



Ø 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. Center does not provide IMS at this time.


Ø Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, child care providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided pursuant 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. Staff was informed that they need to take mandated reporter training.

Ø Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care 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.



Ø *All Licensing reports are available for review on-line 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.

Ø Safe Sleep Information: California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
Ø AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
Ø AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
Ø And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

Ø Fingerprint clearances and transfers: Prior to working or volunteering in a licensed child care 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

No deficiencies are being cited at this time, the facility complies with Title 22

Exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2021
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: BALDY MESA STATE PRESCHOOL
FACILITY NUMBER: 364818021
VISIT DATE: 08/24/2021
NARRATIVE
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**Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. Center utilizes sand and wood chips and artificial turf under climbing structures for cushioning material and there is enough and adequate shade available. Large play equipment and climbing structures are securely anchored. The area was observed to be free of debris. Outside Drinking water is available in the form of a water fountain (it is closed during the COVID-19). Sandboxes are raked and inspected daily and kept free of hazardous foreign materials. There are no bodies of water observed on the premises. The playground is enclosed by a fence to protect children and to keep them in the outdoor activity area.

**This school serves snacks only which are delivered from the cafeteria. Menus observed and posted. Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children



**The Parent Board (located in the main entrance area) contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid (exp 10/2022), **The Parent Board located within the classrooms has contains required licensing forms.

Sign in and out sheets: Both classrooms used electric signature. were inspected and contain full legal signatures. LPA observed a fully stocked first aid kit (in the front door); fully charged fire extinguishers (7/2021); and carbon monoxide detectors (with school ).

Children's and staff records were reviewed.


· The following general information was discussed during this inspection:



Ø 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. Center does not provide IMS at this time.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
LIC809 (FAS) - (06/04)
Page: 3 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: BALDY MESA STATE PRESCHOOL
FACILITY NUMBER: 364818021
VISIT DATE: 08/24/2021
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
Ø Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, child care providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided pursuant 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. Staff was informed that they need to take mandated reporter training.

Ø Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care 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.



Ø *All Licensing reports are available for review on-line 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.

Ø Safe Sleep Information: California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
Ø AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
Ø AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
Ø And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

Ø Fingerprint clearances and transfers: Prior to working or volunteering in a licensed child care 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
No deficiencies are being cited at this time, the facility complies with Title 22
Exit interview conducted and a copy of this report was left at the facility. A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3