300607003-3-4-2020-06-CC-KDEI-BMDS6N-20200304123613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300607003
Report Date: 03/04/2020
Date Signed: 03/04/2020 12:36:21 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:	PEGASUS SCHOOL, THE		FACILITY NUMBER:	300607003
ADMINISTRATOR:	JENNIFER GREEN		FACILITY TYPE:	850
ADDRESS:	19692 LEXINGTON		TELEPHONE:	(714) 964-1224
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY:	75	CENSUS: 32	DATE:	03/04/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Administrator Jennifer Green		TIME COMPLETED:	12:45 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, Required-1 year inspection was conducted on this date by Licensing Program Analyst (LPA) Ketki Desai. Upon arrival, LPA was greeted by the school staff who notified the Director (JG) Jennifer Green, and gave access to the LPA into the facility. When done, LPA was let into the office and the reason for the inspection was stated to the Director, who then guided LPA on a tour of the facility Census: Room # B2 ( 16 preschoolers with two staff and one volunteer who was doing a short presentation) Room B3 : (16 preschoolers with two staff and one volunteer who was doing a short presentation. All staff were verified to be cleared and associated to the pre-school. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. All children were verified to be signed in (Manual sign in sheets are placed in a clip board in each classroom and parents sign in upon arrival and pick up). The Pegasus school has two assigned classrooms on the campus. The Center's days and hours of operation are Mon.-Fri. 7:30 AM. to 6:00 PM. Posting requirements: All posting requirements were observed on the Parent Boards. The license, the Personal Rights, Child Passenger Safety Law, and Notification of Parents Rights are posted on the Parent Board in the front of the entrance gate and these is locked after 9.00 am, which is the official start time of the Pre- K classrooms. Physical Plant: Director guided LPA on a tour of the pre-school classrooms and the pre-school playground. 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 an isolation area with a sink and toilet was inspected. Ill children will remain in the Nurse's office, which is located beside the classrooms. Availability of drinking water was reviewed. In each classroom, there are drinking fountains and Pre- K children also bring in their own individual water bottles. There is a carbon monoxide detector mounted on the wall and is operable.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

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: PEGASUS SCHOOL, THE	FACILITY NUMBER: 300607003
	VISIT DATE: 03/04/2020

NARRATIVE

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Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. There is concrete area, grass area and rubber cushioning underneath the playground equipment. The pre-school teachers bring two classroom at the same time. There is hydration station and drinking fountain accessible to children and restrooms is located in the classroom. The playground is surrounded on all four sides by a five foot fence. The play area was inspected for hazards and inaccessibility to bodies of water. The toys are stored in the locked sheds and cabinets on the playground.

Food Service: Parents have an option to purchase lunch through an on line program offered through school and children bring in their own snacks.
All staff are current on the required First Aid and CPR training, which is valid through 8-1-2021

Health-Related Services: There is one First Aid Kit hung at the end of the classroom door leading towards the play yard, in each classroom. A review of medication policy, including administering, labeling, storage, and records was made.

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 for pre-schoolers.

A random sample of 6 children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day. The child is signed in and out for the person responsible for the child.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

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: PEGASUS SCHOOL, THE	FACILITY NUMBER: 300607003
	VISIT DATE: 03/04/2020

NARRATIVE

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Staff files for staff present during today’s inspection were reviewed for a health screening, immunization’s and mandated reporter training. At least one staff member present possesses current CPR/First Aid certifications, which expires 08/2021. Five staff files were reviewed and contained a health screening as required. Proof of immunization's against influenza (or written decline), pertussis and measles for employees present during today’s inspection were reviewed and within compliance of SB 792. the Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years, per A.B. 1207. Proof of completion as required by AB 1207 was observed in staff files.

An Emergency Disaster Drill log is kept. The last fire drill was ran 02/07/2020.

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.

There were no Title 22 deficiencies cited during today's inspection.

Exit interview was conducted with Director, Jennifer Green. Report reviewed and discussed.

Notice of Site Visit was posted during the visit. Facility representative 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. Appeal rights provided and explained.
The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights.

Facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020

LIC809 (FAS) - (06/04)

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