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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830628
Report Date: 06/16/2022
Date Signed: 06/16/2022 01:02:58 PM

Document Has Been Signed on 06/16/2022 01:02 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:OCS HOLY ROSARY ACADEMY PRESCHOOLFACILITY NUMBER:
364830628
ADMINISTRATOR:AUSTIN, CHERYLLFACILITY TYPE:
850
ADDRESS:2620 N. ARROWHEAD AVENUETELEPHONE:
(909) 886-1088
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 10DATE:
06/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Cheryl AustinTIME COMPLETED:
01:19 PM
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Licensing Program Analyst (LPA) Maddox met with Center Director, Cheryl Austin today for the purpose of conducting an unannounced Annual/Random inspection for this Pre-School component. Upon arrival, LPA counted 10 children present with 2 teachers. Per director, the hours of operation are 07:00 AM -06:00 PM Monday -Friday.
LPA) verified there is at least 2 staff persons present with current CPR and First Aid training.

* Two Snacks are provided and lunch are brought by parents. Allergy lists were reviewed and posted. Food and snacks were reviewed for availability, quantity, proper storage, and appropriateness to children in care. Food preparation areas were toured for safety, cleanliness and proper equipment.
*Disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored in kitchen locked cabinet.

* Bathrooms (2) were toured and LPA noted all toilets were sanitary and operational. LPA observed soap, paper towel and toilet paper and water tested at a safe temperature. The bathrooms are shared with the elementary school children (waiver on file). The classroom has access to a water fountain in the hallway. LPA observed cubbies labeled with children's names.
*Director states carpets are shampooed every 3 months. Close 1 week in Summer for maintenance and carpet cleaning.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628
VISIT DATE: 06/16/2022
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**Teacher/child ratio observed, parent board observed and fire drills are current. Fire extinguisher operable.
*Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair.
*First Aid supplies were inventoried, a review of medication policy, including administering, labeling, and storage.
*Telephone service, heating, lighting and ventilation were evaluated.
Outdoor area and equipment were inspected for safety, cushioning material, good repair and age appropriateness, LPA noted shade from a large tarp covering the entire main play center. There are no bodies of water on the premises. There is a large lawn area. Rubber matting is in place under the swings (which were anchored into the ground) and the climbing apparatus. .
*Isolation area is in the director's office along with the isolation bathroom

ADMINISTRATION:
*Director is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.
*There were no excluded individuals present; staff present were fingerprint cleared and associated.
A review of medication policy indicated that prescription medication is administered only with parent's written permission. The Director administers medication and documents the dosage, date and time onto a log. Medication brought and taken home by the parent daily. Medication is properly labeled and stored in its original container.
*Center was found to be operating within its specified ratio and capacity.
*Sign in and Out sheets were inspected.
Children and Staff files were reviewed as part of this inspection, files reviewed contained emergency contact information, Teacher Qualifications were reviewed.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
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: OCS HOLY ROSARY ACADEMY PRESCHOOL
FACILITY NUMBER: 364830628
VISIT DATE: 06/16/2022
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LPA discussed the following:

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 Centers and ADA, available at: http://www.ada.gov/childqanda.htm
Director is advised to visit www.shotsforschool.org for Immunization information.
Director was informed of responsibility to report suspected Child Abuse, 1-800-540-4000.

Notice of Site Visit must be postd for a perios of 30 consecutive days. No violations were observed as a result of this unannounced inspection. Exit interview conducted, Copy of this report was left with Director after signing.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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