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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750041
Report Date: 11/10/2021
Date Signed: 11/10/2021 04:15:35 PM

Document Has Been Signed on 11/10/2021 04:15 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:APPLE VALLEY CHILD CARE CENTERFACILITY NUMBER:
367750041
ADMINISTRATOR:SHERRY JENKINSFACILITY TYPE:
850
ADDRESS:18609 CORWIN ROADTELEPHONE:
(760) 242-5437
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 55DATE:
11/10/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:07 PM
MET WITH:LAURA DVARECKASTIME COMPLETED:
04:30 PM
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Licensing Program Analysts (LPA's) Maddox and Heath conducted a Pre licensing inspection today for a Change of Ownership for a Preschool component. LPA'a met with new owner, Laura Dvareckas and Director, Sherry Jenkins who guided Analysts on a tour of the center inside and outside. The tour included Office space, Kitchen, 1 staff bathroom, 6 Preschool classrooms, children's bathrooms, and the outside play area. Days/hours of operation will be Monday through Friday from 6am to 6:00pm for children ages 2 thru Kindergarten.

INDOOR ACTIVITY SPACE: There are a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities. Telephone service, heating, lighting and ventilation were evaluated. LPA observed individual storage areas for children’s belongings; Center will use water pitchers with disposable cups; Tables and chairs are provided to meet the needs of the children. The child care center was toured and found to be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees and visitors.

Disinfectants, cleaning solutions, all potential hazardous that could pose a danger if readily available to children were stored and inaccessible to children.

The isolation area (located in the office area) is equipped to isolate and care for any child who becomes ill during the day.

HEALTH RELATED SERVICES:

A refrigerator shall be used to store any medication that requires refrigeration.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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: APPLE VALLEY CHILD CARE CENTER
FACILITY NUMBER: 367750041
VISIT DATE: 11/10/2021
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Applicant has developed a plan to implement and to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.

LPA observed fully equipped first aid kits and hard wired fire systems including Carbon Monoxide detectors.



Pesticides and other similar toxic substances were not stored in food storerooms, kitchen areas, food preparation areas, or areas where kitchen equipment or utensils are stored. Soaps, detergents, cleaning compounds or similar substances were stored in areas separate from food supplies.

Due to the COVID-19 pandemic, applicant has Signs posted throughout the center with regards to the local health department; information on child passenger restraint systems; hand washing, screenings for staff and children, and facial coverings.


Measurements according to facility sketch submitted:

2 yr old Preschool Room: 13 X 12= 156 plus 14 X 11 =154= 310 minus encumbered space 7 Sq ft = 303/35 = 9
3 yr old Preschool Room: 25 X 13 = 325/35 = 9
3.5 yr old Preschool Room: 18 X 19 = 342 - 7.6 = 334/35 = 10
Dining Room area: 12 X 10 = 120/35 = 3
Young 4 yr old Preschool Room: 19 X 19 = 361 minus 18 = 343/35 = 10
Older 4 yr old Preschool Room: 16 X 25 = 400 minus 32 = 368/35 = 11
Kindergarten Room: 23.5 X 15 = 353 minus 12 = 341/35 = 10
Total Indoor Space: 62

Outdoor Space Preschool: 6,872.5/75 = 91
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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: APPLE VALLEY CHILD CARE CENTER
FACILITY NUMBER: 367750041
VISIT DATE: 11/10/2021
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Bathrooms:
6 Toilets and 5 sinks = 75

The facility file was reviewed and the following items are missing:
Immunization's for Laura, Jonathan, and Sherry
Health Screening for Sherry
Health and Safety Training
Mandated Reporter Training for Laura and Jonathan
Admission Agreement and/or Parent Handbook needs updating to mention CCL staff has full Inspection Authority
Statement Acknowledging Requirement to Report Suspected Child Abuse for Jonathan, Laura, and Sherry (LIC 9108)
Criminal Record Statement for Sherry (LIC 508)
Criminal Record Transfer Request for Sherry (LIC 9182)

LPA is unable to Qualify Sherry as the Director, although she was cleared by the Riverside Regional Office as a Teacher. This decision requires an Administrative Review.

With measurements taken today center can accommodate 62 PS children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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