300603559-1-23-2020-06-CC-KDEI-BL4SWZ-20200123131511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300603559
Report Date: 01/23/2020
Date Signed: 01/23/2020 01:15:21 PM

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:	ST MARGARET'S SCHOOL		FACILITY NUMBER:	300603559
ADMINISTRATOR:	LOZON, CRISELDA		FACILITY TYPE:	850
ADDRESS:	31641 LA NOVIA		TELEPHONE:	(949) 661-0108
CITY:	SAN JUAN CAPISTRANO	STATE: CA	ZIP CODE:	92675
CAPACITY:	96	CENSUS: 70	DATE:	01/23/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Director Lozon Criselda & Assistant Director Pipitone Tammy		TIME COMPLETED:	01:30 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), Ketki Desai conducted an on-site inspection for the purpose of the required 1 year annual inspection. LPA and Assistant Director Pipitone Tammy toured the facility inside and outside, floor and yard plan (LIC 999) were verified. This is a Preschool with Toddler option held in assigned eight classrooms . The operating hours are from 7.20 AM to 6.00 PM Monday to Friday. There was a total census of 70 Preschool children with 7 fully qualified teachers 7 teaching assistants, three Administrative staff on premises. Per the facility roster 84 preschool children enrolled, 15 of them are part time enrollees (3 day only) and 10-12 preschoolers receive extended care. Census in each classroom were as follows :(1) Room # 101: 12 Preschoolers with 1 teacher and one assistant. (2) Room # 102 : 11 preschoolers with one teacher and one assistant. (3) Room # 103: 12 preschoolers with one teacher and one assistant. (4) Room # 104 - No children present today. (5) Room # 105: (Toddler room ) 4 Toddlers with one teacher and one assistant. (6) Room # 110 : 10 preschoolers with one teacher and one assistant.(7) Room # 112 : 11 Preschoolers with one teacher and one assistant. (8) Room # 113 : 10 preschoolers with one teacher and one assistant. Classrooms have a scheduled nap time (12.15 to 1.00 PM) Facility provides age appropriate bedding items (Cots/ Mats/ Linens) Linens are washed on premises by the facility staff. Blankets are brought in by the children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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. Observed to be stored in locked cabinets, inaccessible to children. Poisons/Hazardous Items are not kept on the premises.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

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 4

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: ST MARGARET'S SCHOOL	FACILITY NUMBER: 300603559
	VISIT DATE: 01/23/2020

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
26
27
28
29
30
31
32

Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children, via water pitcher and some bring in their own water bottles .The children's bathrooms are clean and sanitary with age appropriate toilet stalls and sink . There is one changing table in toddler classroom and bathroom within sink at arm's length.

The facility has conducted an emergency drill within the past month (12/05/19). The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility office .

Staff files were reviewed present during the facility inspection this date, Four staff files were reviewed. Health screening and immunization's as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a Child Care center day care if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for (staff) were reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires in April 2021 and Administrator : 5/18/2020

Facility Director was informed that the Criminal Record Statement (LIC 508) has been
updated, and the facility must now use the new form with revised date 7/15. Facility Director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance.

Eight Children's records were reviewed, and there was a separate, complete and current record for each child. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed.
Facility has the Manual Sign in and out procedure in place, parents sign in at the reception area upon arrival and during pick up, they are signed out in the classroom. Parents were observed to have completed full legal signatures.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: ST MARGARET'S SCHOOL	FACILITY NUMBER: 300603559
	VISIT DATE: 01/23/2020

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
26
27
28
29
30
31
32

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 Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

IMS medications are stored in a locked cabinet in the Nurse's office on campus and are administered per medical orders and log is maintained. Staff is a licensed Registered Nurse.
Director's office is used as an Isolation area for the child, additional mat with linens observed.

Food Services: Center serves AM snacks to all children , Menus are posted. Children bring in their own Lunch from home. Preschoolers enrolled in Extended day care program are served PM snacks.

The outdoor activity space was inspected for compliance. Play yard, observed to be safe with appropriate fencing, required shade and age appropriate toys. Water fountain and Restrooms are easily accessible to all the preschool children. The surface of the outdoor activity space was well maintained and free of hazards. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The cushioning material rubber foam around the play area appeared to be enough to absorbs falls. Facility follows a free flow schedule for outdoor play from 8.30 to 11.00 am. Children have the option to attend indoor activities too with ongoing staff supervision.

Drinking water in the outdoor activity space is provided by Water fountain.

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The Facility Director was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: ST MARGARET'S SCHOOL	FACILITY NUMBER: 300603559
	VISIT DATE: 01/23/2020

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
26
27
28
29
30
31
32

In the areas that were evaluated, no deficiency were observed under California Code of Regulations, Title 22, Division 12 at the time of the visit.

An exit interview was completed with Facility Administrator The report was reviewed and discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

Page: 4 of 4