300602295-9-30-2019-06-CC-KDEI-BGHPYP-20190930114418

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300602295
Report Date: 09/30/2019
Date Signed: 09/30/2019 11:44:29 AM

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:	HEPHATHA LUTHERAN CHURCH PRESCHOOL		FACILITY NUMBER:	300602295
ADMINISTRATOR:	DARLENE FOWLER		FACILITY TYPE:	850
ADDRESS:	5900 E SANTA ANA CANYON RD		TELEPHONE:	(714) 637-0887
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY:	97	CENSUS: 84	DATE:	09/30/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Director Terri Mora		TIME COMPLETED:	12:00 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	An unannounced annual random inspection was conducted on this date by Licensing Program Analyst (LPA) Ketki Desai . Upon arrival, LPA was greeted by preschool teacher who guided the LPA to the Director office located at the end of the classrooms. Director Terri Mora is the new Director and accompanied LPA on a tour of the facility. The Preschool program here offers a Full day and a half day programs with AM/PM sessions in the assigned eight classrooms on the campus. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearances. Census: Room #1: 11 children with one staff / Room # 2: 9 children with one staff / Room # 3 10 children with one staff / Room # 4 : 12 children with one staff/ Room # 5 : 10 children with one staff/ Room # 6 : 11 children with one staff/ Room # 7 : 11 children with two staff and Room # 8 10 children with one staff. ( Child - Teacher ratio observed) Additional support staff were also observed providing additional care and supervision . Teachers and additional supporting aides were observed during outdoor activities ensuring the children received care supervision and support. The Center's days and hours of operation are Monday- Friday 7.00 to 6.00 PM ( Full day session) : 7 am to 6.00 PM/ 8.45 to 3.00 PM Half day sessions : 7 AM to 12.30 PM / 8.45 - 12.30 PM Children in full day session are Nappers while Children enrolled in Half day sessions are Non- Nappers. Posting requirements: All posting requirements were observed on the Parent Boards. The license, the snack and lunch menu, the Personal Rights, Child Passenger Safety Law, Notification of Parents Rights, Emergency disaster plan are posted on the Parent Board.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

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: HEPHATHA LUTHERAN CHURCH PRESCHOOL	FACILITY NUMBER: 300602295
	VISIT DATE: 09/30/2019

NARRATIVE

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Health related Services: There is one First Aid Kit in each classroom hung near the exit doors. Director and staff are trained by Health Educators who provide the needed IMS treatment to the child. 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 ,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 Care Centers and the ADA, available athttp://www.ada.gov/childqanda.htm www.ada.gov/childqanda.html.

Transportation: This facility does not provide transportation services

An Emergency Disaster Drill log is posted. The last fire and earthquake drill was run 9-3- 2019 and 9-4-19.

Teacher child ratios were observed and staff names recorded. Care and supervision was evaluated to determine if the basic needs of children are met appropriately.
Sign in and out sheets and procedures were reviewed with Director as was the policy of checking children for illnesses. Children are sign in / out by parents upon arrival and later during pick up time. Personal Rights of children were discussed and observed by LPA. Per Director, there are currently no firearms or weapons on the premises.
File review: A random sampling of 8 preschoolers' files and six staff files were reviewed for completeness, including, but not limited to Criminal Record Clearances for adults, qualifications and verification of CPR/First Aid for the openers and closers. All the files are kept in the main office . Emergency cards are available for review. Staff present on premises are current on Infant CPR/ First Aid along with Immunization's and Mandated Reporting training.

No deficiency cited per title 22 on today's inspection.

Upon receipt, Director Terri Mora posted the Notice of Site Visit.

The Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. An exit interview has been conducted with, and a copy of this report has been signed by and provided to Director.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

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: HEPHATHA LUTHERAN CHURCH PRESCHOOL	FACILITY NUMBER: 300602295
	VISIT DATE: 09/30/2019

NARRATIVE

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Physical Plant: Facility designee guided LPA on a tour of the facility, All the Eight classrooms were observed, Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating and air-conditioning, lighting and ventilation were evaluated. Storage for children's belongings and toilets were inspected. The restrooms are shared in the four classrooms, three classroom have restrooms inside the classrooms only one classroom # 5 ( TK classroom) children use the restroom located outside the classroom. Each of the restrooms were observed to be clean and sanitary with the needed products. Age appropriate stalls and sinks observed. There is separate restroom used by the children during outdoor activities across the play yard.

If a child is ill, they are brought into the Director's office and mat with linens are in the office . Availability of drinking water was reviewed , each classroom was observed to have a Water pitcher with small cups and during outdoor activities water fountain was observed in the play yard. Children also have the option to bring in their own water bottles
There is a Fire extinguisher, smoke and carbon monoxide detector mounted on the wall it was tested and is operable.

Play Yard: All the Eight Preschool classrooms use the same yard on the premises and have a different schedule. Each room has a separate exit door leading to the yard. Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. There is concrete and grass on the playground, Water fountain observed. The playground is surrounded on all four sides by a five foot high metal fence. The play area was inspected for hazards and inaccessibility to bodies of water. The toys are stored in the locked shed. Staff were observed providing care and supervision during out door activities.

Food Service: The Center serves AM/ PM snacks which is brought out by the kitchen staff. Center does offer Lunch catered through a vendor ( Cater tots) where the parents have an option to purchase on line and is delivered on the premises while those children who bring in their own lunch bags, they stored in a lunch cart. Monthly snack menus are posted in each classroom/ Parent board and the Kitchen area. Kitchen is on premises where the staff prepares the trays and is delivered to each room.

Napping: Children attending the full day sessions nap in the classroom. Mats are labelled and are stored appropriately. Linens are provided by the center but are washed by parents on a weekly basis.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

LIC809 (FAS) - (06/04)

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