364818021-8-30-2022-12-CC-BIBE-CHSS2Z-20220830133022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364818021
Report Date: 08/30/2022
Date Signed: 08/30/2022 01:30:34 PM

Document Has Been Signed on 08/30/2022 01:30 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 PRESCHOOL		FACILITY NUMBER:	364818021
ADMINISTRATOR:	KIMBERLY MARTIN		FACILITY TYPE:	850
ADDRESS:	10376 BALDY MESA ROAD		TELEPHONE:	(760) 868-6229
CITY:	PHELAN	STATE: CA	ZIP CODE:	92329
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 34	DATE:	08/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:59 AM
MET WITH:	CORENE RUDOLPH		TIME COMPLETED:	01:58 PM

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Licensing Program Analyst (LPA) Babatunde Ibitoye met with lead teacher Angelica Goint today for the purpose of conducting an unannounced Required 1 year Annual inspection. During this inspection, the site supervisor Corene Rudolph, arrived. The remainder of this inspection was conducted with the Site supervisor. This State Preschool occupies k1 and k2. k 1 had 3 staff (2 teacher, 1 sub, with 16 children) and k2 had 3 staff (2 teacher and 1 sub with 18 children). This State Preschool is held on the site of Baldy Mesa Elementary School in Phelen, the hours of operation are (2 sessions) Mon - Fri from 8:00 AM -11:00 and from 11:45am to 2:45. This preschool is closed for the summer from June 7 to August 14. There is a waiver on file for the Pre-school children to share the play yard, there is a staggered play yard schedule.

During the time of the inspection, LPA observed and reviewed records to verified accuracy:
1. Sampling of children's (5) records (See LIC 857)

2. Sign in and Out sheets were inspected.

3. Emergency contact information observed

4. Parent board observed

5. Staff personnel files reviewed for educational and certification (See LIC 859 )

6. Pediatric CPR and First Aid training for one staff

7. Mandated Reporter Training

8. Emergency Fire Drills were current and up to date

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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: BALDY MESA STATE PRESCHOOL	FACILITY NUMBER: 364818021
	VISIT DATE: 08/30/2022

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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.(POD)

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children were stored and inaccessible to children . LPA observed 1 microwave, 1 refrigerator

**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 . Sandboxes are raked and inspected 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.

**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 12/26/2023), **The Parent Board located within the classrooms has contains required licensing forms.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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: BALDY MESA STATE PRESCHOOL	FACILITY NUMBER: 364818021
	VISIT DATE: 08/30/2022

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Sign in and out sheets: Both classroom. were inspected and contain full legal signatures. LPA observed a fully stocked first aid kit (in the front door); fully charged fire extinguishers and carbon monoxide detectors .

· The following general information was discussed during this inspection:

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 provide IMS as needed by the school Nurse.

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.

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.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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: BALDY MESA STATE PRESCHOOL	FACILITY NUMBER: 364818021
	VISIT DATE: 08/30/2022

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*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.
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, LPA Issued
1 Technical assistance for Mandated Reporter Training.
Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted with Site Supervisor Corene Rudolph. A copy of the Appeal Rights (LIC 9058) was given and explained. Site supervisor signature on this form acknowledges receipt of these rights.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC809 (FAS) - (06/04)

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