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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270035
Report Date: 12/30/2020
Date Signed: 12/30/2020 01:09:04 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:FULLERTON FREE PRESCHOOLFACILITY NUMBER:
304270035
ADMINISTRATOR:ERNST, STEFANIFACILITY TYPE:
830
ADDRESS:2801 BREA BLVD.TELEPHONE:
(714) 529-5544
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:30CENSUS: 0DATE:
12/30/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Stefani Ernst, DirectorTIME COMPLETED:
11:30 AM
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Tele-Inspection COVID-19 State of Emergency

Licensing Program Analyst (LPA) Stacy Torrence conducted a case management tele-inspection, via facetime, due to facility requesting to change rooms in the infant program. Facility is currently licensed for 30 infants in rooms 111 and 112, located in Building B, and requesting to move the infant program to rooms 118 and 122 also located in Building B; however, the rooms are located inside the fenced area of the facility. The capacity remains the same. LPA Torrence virtually toured the infant program with Director Stefani Ernst. The new rooms were inspected and measured, with the assistance of two employees, and is deemed adequate for the room changes. The facility is on winter break; therefore, there were no infants present during today’s tele-inspection.

A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances

Fire clearance for inspection conducted on 12/28/2020 and was granted.

Indoor Space Activity Space:


Room 118= 26.2 x 23.1 = 605.22 sq. divided by 35= 17 infants
Room 122= 29.8 x 32.8 = 688.38 sq. – 194.88(encumbered) = 493.5 divided by 35= 14 infants
There are no cribs in room 118, as the infants in this room are transitioning into the toddler room and will use cots/mats as napping equipment. The infant indoor is physically separate from the preschool/toddler components.

Outdoor Activity Space:


Infant Playground: 29.2 x 32.8 = 688.38 sq. divided by 75= 9 infants
Infant playground will be utilized on a rotating schedule. The playground is fully enclosed by appropriate fencing. An adequate amount of cushioning material consisting of foam mat is in place under all play equipment. Adequate shade is provided by several canopies.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2020
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: FULLERTON FREE PRESCHOOL
FACILITY NUMBER: 304270035
VISIT DATE: 12/30/2020
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The infant program will not be using potty chairs. There was a sink, in each room, within arm reach of a changing table.

Facility is adequate for room change. License, effective this date, will note operating hours: Monday through Friday, 8:00 AM to 5:00 PM in rooms 118 and 122; for ages 6 weeks to 2 years: capacity 30.

No deficiencies were observed during today's tele-inspection.

Exit interview was conducted with Director Stefani Ernst, via tele-Inspection. Report was read and discussed. A copy of the report and Appeal Rights will be emailed to director with a Read Receipt to acknowledge report was received. If Read Receipt is not functional, director will respond to email stating “I have read and received the report, I acknowledge receipt.” LIC 809 will also be mailed if those options are not available.

SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2020
LIC809 (FAS) - (06/04)
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