304270153-12-28-2023-06-CC-PRIS-CYXR97-20231228114905

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270153
Report Date: 12/28/2023
Date Signed: 12/28/2023 11:49:28 AM

Document Has Been Signed on 12/28/2023 11:49 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	FAIRMONT PRIVATE SCHOOL		FACILITY NUMBER:	304270153
ADMINISTRATOR:	LERMA, TALIA		FACILITY TYPE:	850
ADDRESS:	5310 EAST LA PALMA		TELEPHONE:	(714) 693-3812
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY:	148	CENSUS: 0	DATE:	12/28/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Talia Lerma, Director//Applicant		TIME COMPLETED:	12:30 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	Licensing Program Analyst (LPA) P Rivas conducted an announced case management visit to review a request in increase in capacity from 148 to 162 pre school children by adding room #1. A review of the Facility Personnel Report Summary 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 or exemptions. The facility has requested to provide care and supervision to 162 preschool children ages 2 years to 5 years old. The hours of operation are from Monday thru Friday, 7:30 am to 5:30 pm. The current preschool classrooms are in rooms A, B, C, D, E, #5 and #10 . The facility has a waiver in place for the occasional use of other rooms: #11 (Art Room), Music Room, Library, #9 (Computer) #3 (Kinder Music Room), Multipurpose Room, Gymnasium, and Playground/Turf Area throughout the week. The preschool children do not commingling with any school-age children at anytime. The preschool staff are with the preschool children and the school-age staff during these hours when the preschool children are using these classrooms. During today's visit, LPA toured the facility including the extra rooms to ensure that they are safe for the preschool children to use. Fire clearance received from the Anaheim Fire Prevention Authority on 10/26/23 approving the requested capacity of increase of 162 pre school children. LPA inspected rooms A, B, C, D, E, 5, 10 AND #1. There is carbon monoxide and fire extinguisher throughout the facility.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (916) 936-5444
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: FAIRMONT PRIVATE SCHOOL	FACILITY NUMBER: 304270153
	VISIT DATE: 12/28/2023

NARRATIVE

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The outdoor activity area is supplied with age and size appropriate equipment with adequate of cushioning materials made of pour and play and rubber mulch chipsunder the climbing structure and slide.
Total indoor measurement for Rooms 1, 5, 10, A, B, C, D, E was 5745.66 square feet.

Toilets: 11 X 15= 165 children
Sinks: 13 X 15 = 195 children.

Outdoor Activity Space:
The preschool outdoor space measurement is 8290 square feet.

Based on the total measurements for the preschool the requested capacity was met.

The Director submitted a waiver request for the preschool playground to accommodate the requested capacity of 162 preschool children.

The request for a capacity increase will be submitted for final review. The facility will be notified if any additional information is required.

An Inspection and exit interview were completed with the director. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (916) 936-5444
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023

LIC809 (FAS) - (06/04)

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