300614170-5-7-2019-06-CC-ATAR-BBXU7E-20190507151949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300614170
Report Date: 05/07/2019
Date Signed: 05/07/2019 03:19:59 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:	WALTER HEAD START		FACILITY NUMBER:	300614170
ADMINISTRATOR:	BREAUX, SHAUNEE		FACILITY TYPE:	850
ADDRESS:	9200 PACIFIC PLACE		TELEPHONE:	(714) 761-4967
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	52	CENSUS: 41	DATE:	05/07/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Shaunee Breaux-Director		TIME COMPLETED:	03:30 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	An unannounced inspection for an Annual/Random of the facility was conducted by Licensing Program Analyst (LPA) Andrea Taylor. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance. Operating hours are 7:30 am- 5:30 pm, Mon-Fri. Census was taken. LPA observed 41 preschool children with 8 staff members and the Director. The facility was toured inside and outside. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. 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 kept on the premises. Food is brought in by outside vender. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children both indoors and outdoors. The children's bathrooms are clean and sanitary. Only the children who attend full day nap. They nap on cots/mats, and bedding is washed by staff once a week. The facility has conducted an emergency drill within the past six months. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The playground was completely fenced. The playground equipment appeared in safe condition. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Sign in/out procedure was reviewed for compliance. During today's visit staffing ratios were being met. At least one staff member present possesses current CPR/First Aid certifications, which expires 7/20. Children and staff files were reviewed for compliance. Children and staff files were in substantial compliance. In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (714) 703-2820
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019

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: WALTER HEAD START	FACILITY NUMBER: 300614170
	VISIT DATE: 05/07/2019

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Proof of immunization against pertussis and measles for all employees/volunteers were reviewed for compliance with SB 792.

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov.

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative.
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

Exit interview was conducted. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Appeal rights provided and explained. The director was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

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 $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (714) 703-2820
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019

LIC809 (FAS) - (06/04)

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