304270105-10-10-2019-06-CC-WPOT-BGTPE2-20191010111426

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270105
Report Date: 10/10/2019
Date Signed: 10/10/2019 11:14:44 AM

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:	JEANNE HARDY HEAD START		FACILITY NUMBER:	304270105
ADMINISTRATOR:	VARGAS, MARIA LIZET		FACILITY TYPE:	850
ADDRESS:	17175 EMERALD DRIVE		TELEPHONE:	(714) 842-1221
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92647
CAPACITY:	68	CENSUS: 39	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Maria Lizet Vargas, Director		TIME COMPLETED:	11:30 AM

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 inspection was conducted at the facility by Licensing Program Analyst (LPA) Port. 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. Staff #2 was not associated to the facility prior to commencing employment at the facility. This facility has a master staff association agreement on file with the licensing office. Operating hours are 7:30 AM to 5:30 PM, Monday through Friday. Upon arrival LPA met with Director, Maria Lizet Vargas who guided LPA on a tour of the facility. LPA observed 6 preschool children and 2 staff members in Room #1, 6 preschool children and 2 staff members in Room #2, 14 preschool children and 2 staff members in Room #3, and 13 preschool children and 2 staff members in Room #4. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The facility was toured inside and outside and the floor and yard plan were verified. The facility representative stated there is no bodies of water onsite. LPA confirmed with facility representative that firearms/weapons are not allowed or stored on premises. The facility appeared clean and orderly. The items which could pose a danger to children (disinfectants and cleaning solutions) were stored out of the reach of children. Poisons/Hazardous Items are not stored on site and none were observed during today's inspection. All materials and surfaces accessible to children are toxic free. Medications are in a safe place inaccessible to children. The children’s bathrooms were observed to be in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Food is delivered by a third party company: lunch and snacks are provided. Food prep areas appear clean and sanitary. Food is properly stored. On site food prep area in each classroom is free from hazards. There is a dated menu posted in a prominent location viewable by authorized representatives. Solid waste receptacles have a tight-fitting cover and are in good repair. Children nap on cots/mats, and bedding is laundered daily by the facility. Page 1 of 3 (Continued on Page 2)

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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: JEANNE HARDY HEAD START	FACILITY NUMBER: 304270105
	VISIT DATE: 10/10/2019

NARRATIVE

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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

Facility representative 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 Department of Social Services Lead Information brochure was given to the director.

The following violation of the California Code of Regulations, Title 22; Division 12, was observed and cited during today's inspection: Criminal Record Clearance 101170(e)(2) see LIC 809D.

Exit interview was conducted with Director Maria Lizet Vargas and Rose Alvarez, Education Manager. 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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: JEANNE HARDY HEAD START	FACILITY NUMBER: 304270105
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/10/2019 Section Cited	1 2 3 4 5 6 7	Criminal Record Clearance 101170(e)(2) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on record review Staff #2 (Kimberly Castro's) criminal record clearance had not been associated to the facility (master association agreement). Based on the interviews conducted Ms. Castro has worked as a substitute teacher since 10/07/2019. This poses a potential safety risk to children in care. A civil penalty has been assesed.	8 9 10 11 12 13 14
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: JEANNE HARDY HEAD START	FACILITY NUMBER: 304270105
	VISIT DATE: 10/10/2019

NARRATIVE

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There is drinking water available to children both indoors and outdoors. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher that meet statutory requirements.

The playground was completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. There is sufficient rubber cushioning underneath climbing structures and/or play equipment to absorb falls.

A random sample of six 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 full 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.

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 08/22/2020. Ten 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. 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.

This facility provides Incidental Medical Services -IMS. LPA reviewed storage of medication, 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 and 101226.

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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