300603559-2-11-2021-06-CC-STOE-BY623U-20210211160255

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300603559
Report Date: 02/11/2021
Date Signed: 02/11/2021 04:03:06 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: 39	DATE:	02/11/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Diane Fletcher, Assistant Director		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 case management inspection was conducted on this date by Licensing Program Analysts (LPAs) Stacy Torrence and Lou VanZant for the purpose of adding a room. The facility had an emergency waiver to use classroom #109. The emergency waiver expired on 02/05/2021. The facility has requested to permanently add classroom #109 to their license. The facility is currently licensed for 96 children and is not requesting an increase in capacity. The facility is currently licensed for classrooms 101-105, 110, 112, and 113. This is a Preschool with Toddler option. LPAs met with Assistant Director Diane Fletcher, who guided analysts on a tour of the facility. Census was taken. There was a total of 39 preschool children present, with 14 staff supervising. Operations hours are Monday-Friday; 7:20 a.m.-6:00 p.m., serving children ages 2-6 years old. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. All areas identified on the Facility Sketch were inspected. If children become ill during the day, they will rest in the isolation area located, in a separate building, where there are two nurses present. The children will be quarantine in their own room. There are also bathrooms at this location for the children to use. Medication will be stored in the nurse’s office. Furniture and equipment were inspected for age appropriateness and good repair. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. Children bring their own water bottles from home, and there is a touchless filter water dispenser, located outside, available for the children to re-fill their bottles. First Aid supplies were inventoried. Sign in / sign out record meets regulation requirements.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

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: ST MARGARET'S SCHOOL	FACILITY NUMBER: 300603559
	VISIT DATE: 02/11/2021

NARRATIVE

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During this time, snacks and lunch is provided by the parents.
Indoor Activity Space Measurements:
Classroom #101: 508 sqft.
Classroom #102: 508 sqft.
Classroom #103: 508 sqft.
Classroom #104: 508 sqft.
Classroom #105: 476 sqft.
Classroom #109: 478 sqft. - Added Room
Classroom #110: 508 sqft.
Classroom #112: 540 sqft.
Classroom #113: 468 sqft.
Total= 4499 sqft. divided by 35 = 128 children

Total children toilets and sinks:
toilets 16 x 15 = 240 children
sinks 17 x 15 = 255 children

Outdoor Activity Space Measurements:
Total= 10,173 sqft. divided by 75=135 children
Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment. An adequate amount of cushioning material(wood chips and sand) is in place under the equipment. Shade is provided by trees, canopies, and umbrellas.

Fire clearance approval letter on file and dated 10/16/2020, adding room #109.

Facility provides Incidental Medical services.

In the areas evaluated, no deficiency was observed and cited today per CA Code of Regulations, Title 22, and Division 12.

Exit interview was conducted. A copy of this report and appeal rights were discussed and provided to the director. The Notice of Site Visit was posted. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2021

LIC809 (FAS) - (06/04)

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