304270260-6-25-2019-06-CC-GCOY-BDGRR8-20190625131443

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270260
Report Date: 06/25/2019
Date Signed: 06/25/2019 01:14:50 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:	ST. ANNE EARLY CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	304270260
ADMINISTRATOR:	SLOCUM, DENISE		FACILITY TYPE:	850
ADDRESS:	32451 BEAR BRAND ROAD		TELEPHONE:	(949) 276-6781
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	104	CENSUS: 15	DATE:	06/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Denise Slocum		TIME COMPLETED:	01:30 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 annual inspection was conducted at this facility by Licensing Program Analyst (LPA) Connolly. The facility file was reviewed prior to this inspection being conducted. LPA met with director Denise Slocum who accompanied the LPA on a tour of the facility inside and outside. There were 15 children in care with 3 attending staff. A review of staff 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. During the school year the facility, clean and in good repair, operates 7:00 AM to 6:00 PM Monday through Friday in rooms B 120, B 124, B 117, B 121, B 125, B 129, B 126 and B 130. The facility is currently operating a summer program utilizing rooms B 120 and B 126 only. During the tour of the facility the LPA observed that items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons are stored in a janitorial closet. Snacks are provided and lunches can be purchased on line from a vendor or brought from home. The on site snack food prep area appeared clean and sanitary. Food is properly stored. On site kitchen is free from hazards. 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. Children nap on mats, and bedding is laundered weekly at home. In each room there is a smoke detector and carbon monoxide detector. Both appeared in good working order. The fire extinguisher located in the hallway is within regulation. The facility has conducted an emergency drill within the past six months. Documentation was provided. At least one staff member present has pediatric CPR and First Aid health cards which expire August 2019. Continued on page two

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 703-2822
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2019

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: ST. ANNE EARLY CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 304270260
	VISIT DATE: 06/25/2019

NARRATIVE

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The playground is completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Within the large playground the facility has established a separate area for the two year old children. This area is enclosed by fencing. Play equipment appears age appropriate.

Sign in/out procedure was reviewed for compliance. Children's and staff files were reviewed for compliance. Proof of immunization against pertussis, influenza (or written declination), and measles for all employees/volunteers were reviewed for compliance with SB 792. Certificate for successfully completing mandated reporter training was in each staff file reviewed.

Incidental Medical Services (IMS) policy was discussed as this facility cares for children who need incidental medical services. LPA reviewed storage of medication and equipment/supplies and reviewed children’s personnel and administrative records. The facility has a registered nurse on site. 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

Exit interview was conducted, and report 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 director 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. 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 Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 703-2822
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2019

LIC809 (FAS) - (06/04)

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