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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300614059
Report Date: 06/26/2019
Date Signed: 06/26/2019 03:05:36 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:TURTLE ROCK SCHOOL AGE CDCFACILITY NUMBER:
300614059
ADMINISTRATOR:HO, MINDYFACILITY TYPE:
840
ADDRESS:5151 AMALFI DRIVETELEPHONE:
(949) 854-5060
CITY:IRVINESTATE: CAZIP CODE:
92603
CAPACITY:70CENSUS: 22DATE:
06/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Mindy Ho, DirectorTIME COMPLETED:
03:30 PM
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An inspection was conducted at the facility by LPA Dean Valencia. The facility file was reviewed prior to this inspection being conducted. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance.

Operating hours are 7am to 6pm, Mon-Fri, open year round. The facility is located in rooms CC1 and CC2 on the campus of Turtle Rock Elementary. The facility was toured inside and outside and the floor and yard plan were verified. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. There were 4 staff and 22 children present during the inspection. The facility appeared clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons/Hazardous Items are not stored on site and none were observed. Food is prepared on site; snacks, breakfast and lunch are provided. Food prep areas appear clean and sanitary, food is properly stored. The facility has a monthly/weekly menu posted and is up to date. There is drinking water available to children both indoors and outdoors. The children's bathrooms are clean and sanitary. Some outdoor restrooms are shared with the school campus. The facility has conducted an emergency drill within the past six months, and is documenting them. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The playground is completely fenced and fencing is in good repair. The playground equipment appeared in safe condition, and the play area is free from hazards. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. The outdoor play area is shared with the school campus. Sign in/out procedure was reviewed for compliance. Staff have proof of current pediatric CPR/First Aid certification, which expires 12/14/2020. Children's and staff files were reviewed, and are within compliance. Incidental Medical Services (IMS) policy was discussed.
(continued on LIC809C)
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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 2
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: TURTLE ROCK SCHOOL AGE CDC
FACILITY NUMBER: 300614059
VISIT DATE: 06/26/2019
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For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.
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
Proof of immunization's against pertussis, influenza (or written declination), and measles for all employees/volunteers are on file and within compliance. All licensing reports are public information and must be made available upon request. This report was reviewed and discussed with the the care provider. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. The training certificates were reviewed and discussed with the director
A pamphlet of Effects of Lead Exposure was provided for care provider and discussed.

Exit interview was conducted, and report, deficiencies, and advisory notes was reviewed and discussed. Notice of Site Visit was posted during the visit. The 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 per day. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional manager, address is above on the report. The facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. and accessibility and access to the website was discussed with the care provider. This report is to be on file and accessible for public review at the facility for at least 3 years.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2