300600959-7-20-2022-06-CC-KDEI-CGGUTY-20220719155243

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300600959
Report Date: 07/19/2022
Date Signed: 07/20/2022 01:58:27 PM

Document Has Been Signed on 07/20/2022 01:58 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	TEMPLE BETH SHOLOM CHILDREN'S LEARNING CENTER		FACILITY NUMBER:	300600959
ADMINISTRATOR:	LEVIN, TAMARA		FACILITY TYPE:	850
ADDRESS:	2625 NORTH TUSTIN AVENUE		TELEPHONE:	(714) 628-4640
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92705
CAPACITY:	60	CENSUS: 37	DATE:	07/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator Ms. Levin, Tamara		TIME COMPLETED:	04:15 PM

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	Licensing Program Analyst (LPA), Desai, Ketki conducted an unannounced Required 1 Year inspection and Case Management inspection for a Change of Capacity at the facility on today's date. LPA, Desai toured the facility with the director, Tamara Levin inside and outside. Currently facility is licensed for 60 children in the six assigned rooms. Facility now is requesting an increase in capacity to 92 children in the currently licensed rooms ( Room # 2, 3,4, 7, 8 and 11) . Census was taken in individual classrooms. The overall census observed was 6 preschool staff and 37 preschool children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Operating hours are 7:30 am- 6:00 PM, Mon-Fri. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Children bring in their own lunch and snacks are provided by the Facility and Menu's are posted in each rooms. Floors, equipment, and furniture were clean and observed to be in good repair and free of sharp edges. There is drinking water available to children indoors through Brita Filtered pitchers and personal water bottles. The children's bathrooms are clean and sanitary. Children nap on cots, bedding is stored individually and is taken home daily to be washed by parents. The facility has conducted an emergency drill within the past six months and keeps documentation of drills. The facility has working smoke detector, working carbon monoxide detector and functioning fire extinguisher and the newly installed Sprinkler system. Facility meets all posting requirements. The outdoor activity space was inspected for compliance. The playground is enclosed by a fence at least four feet in height and is in good repair. Infant yard is separate from the preschool yard. There is sufficient shade in each yard. (1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH SHOLOM CHILDREN'S LEARNING CENTER	FACILITY NUMBER: 300600959
	VISIT DATE: 07/19/2022

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The surface of the outdoor activity space is maintained and free of hazards. The cushioning material around outdoor play equipment and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided. The outdoor equipment and toys are in good repair and free of sharp edges. There are no bodies of water present at the facility. There is one toilet and sink in the outdoor play yard.

The inspected outdoor facility grounds are safe, sanitary and in good repair. Staff files were reviewed for staff present during the facility inspection on this date.
On today's inspection, All the Preschool rooms were measured today.

Currently facility is licensed for 60 preschool age children in the six classrooms.
Now facility is requesting a change in capacity for the preschool program increasing the capacity to 92 Preschool age children in the current six classrooms.
Facility has an Infant program in two classrooms (1& 6) with a capacity of 24 Infants.

Classrooms were observed to have the following
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through water pitchers with disposable cups and personal water bottles.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements, including Sprinkler system.
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Cots are used and are stored in the closet area, napping linens and blankets are brought from home
There are toilets and sinks in the classroom for the preschool children.

Indoor activity space for Preschool: All the six rooms were measured on today's inspection.
Indoor space= 4159'68 divided by 35 = 118'85 (119 children) Facility has sufficient space to accommodate the requested capacity of 92 children in the six rooms.

(2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH SHOLOM CHILDREN'S LEARNING CENTER	FACILITY NUMBER: 300600959
	VISIT DATE: 07/19/2022

NARRATIVE

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Outdoor space : Preschool has designated yard for the preschool classrooms. Outdoor yard was observed to be completely fenced, with age appropriate climbing structures, bikes, additional outdoor toys. Infant yard is separate.
Outdoor space ( Measured : October 2019 remains current)

Outdoor space: 8750 divided by 75= 116'66 (117) facility has sufficient out door space to accommodate the requested capacity.

Total sinks and toilets in preschool room
8 toilets x 15 children = 120 (room#2,3,4=1 toilet each, room#7,8=2 toilets each, outdoor=1 toilet)
16 sinks x 15 children = 240 (room#2,3,4 = 2 sinks each, room#7,8 = 4 sinks each, room#11 = 1 sink, outdoor = 1 sink)

Based on the indoor and outdoor measurements, sink and toilet availability, facility has sufficient space to accommodate 92 Preschool age children (2-6 years old) in six assigned rooms.

Fire clearance received from Orange County Fire Authority have approved the requested capacity 92 preschool age children and 24 Infants . Total capacity: 116 children.

Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through 8/2022 and have provided the completion certificate for Mandated Reporter training certificate. Facility Director and school staff have their annual CPR/First Aid training in the month of August.

During the Exit Interview, LPA discussed the following with the Facility Director Ms. Levin, Tamara

Criminal Record Statement: Facility Representative Ms. Levin Tamara was was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. (3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH SHOLOM CHILDREN'S LEARNING CENTER	FACILITY NUMBER: 300600959
	VISIT DATE: 07/19/2022

NARRATIVE

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Safe Sleep :
LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative Ms.Levin, Tamara the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS)

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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

To receive important license -related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No deficiencies were cited on today's inspection. Staff and Children's files were reviewed on today's inspection.

Notice of Site Visit : A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

This report was read and presented to the Facility Director Ms. Levin , Tamara along with the Appeal Rights.

A new license with a total capacity of 116 children : 92 Preschool age children (2-6 years old) in Room # 2,3,4, 7, 8 and 11, with 24 Infants in Room # 1 and 6, shall be issued upon management approval.

Exit interview conducted.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

LIC809 (FAS) - (06/04)

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