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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605571
Report Date: 10/05/2021
Date Signed: 10/05/2021 03:13:13 PM

Document Has Been Signed on 10/05/2021 03:13 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:RAINBOW AFTER-SCHOOL CARE & PRE-K PROGRAMFACILITY NUMBER:
300605571
ADMINISTRATOR:BARTELS, ALISONFACILITY TYPE:
840
ADDRESS:4343 PICKWICK CIRCLETELEPHONE:
(714) 846-8386
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92649
CAPACITY: 215TOTAL ENROLLED CHILDREN: 0CENSUS: 15DATE:
10/05/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Owner/Adminsitrator Ms.Tay ArmstrongTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced Case Management Licensee initiated inspection for a change in capacity. Licensee is requesting a change to the current School age capacity from 215 to 152 school age children (6-14 years) Licensee is decreasing the capacity by removing Multipurpose room. Licensee is also adding one room # 37 to its School age program. Originally Room # 37 was under Pre-school license.

LPA met with Facility Administrator Ms. Armstrong Tay, who gave a tour of the Five School age classrooms (Room # 33,34,35,36 and 37)

All areas identified on the Facility Sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair in the School age rooms. First Aid supplies were inventoried. Playground is completely enclosed by a fence. Outdoor activity area is supplied with age and size appropriate equipment including a climbing structure. An adequate amount of cushioning material is in place under the equipment. Drinking water is available through personal water bottles and Water pitchers. A review of medication policy, including administering, labeling, storage, and records were made, disaster drills, posting requirements, children records, mandated child abuse and injury/death reporting, and criminal records clearances/exemption transfer requests.


Facility shall continue to use the School play yards and bathrooms designated for the program.

Based on today's inspection facility has enough space for the requested capacity of 152 children in the five assigned rooms.

Facility has provided a district permission letter indicating the occupancy in each of the five school age rooms.
Administrator Ms. Armstrong is current on the required CPR training (11/21) (Page-1)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2021
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: RAINBOW AFTER-SCHOOL CARE & PRE-K PROGRAM
FACILITY NUMBER: 300605571
VISIT DATE: 10/05/2021
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Based on the indoor measurements, Facility shall be granted an approval for 152 school age children (6-14 years old) in the five assigned rooms (33,34,35,36 and 37).

License shall be granted after the final approval by the management.

Report was read to the Facility Administrator and appeal rights were provided.

Notice of site visit posted.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC809 (FAS) - (06/04)
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