304270318-5-15-2019-06-CC-SHAS-BC7RBP-20190515125304

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270318
Report Date: 05/15/2019
Date Signed: 05/15/2019 12:53:11 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:	HEIDEMAN SCHOOL AGE CDC		FACILITY NUMBER:	304270318
ADMINISTRATOR:	SCIORTINO, DAN		FACILITY TYPE:	840
ADDRESS:	15571 WILLIAMS STREET		TELEPHONE:	(714) 834-0441
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	105	CENSUS: 1	DATE:	05/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Dan Sciortino		TIME COMPLETED:	01:10 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	Licensed Program Analyst (LPA) Hawkins arrived at the facility for the purpose of conducting an Annual/Random inspection. LPA met with Dan Sciortino, Director and inspected the facility. 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 AM to 7:45 AM before school and after school until 6:00 PM, Monday thru Friday. The center operates during Tustin Unified School District Spring/Winter breaks and during Summer. Census was taken and LPA observed 1 school age child with 2 staff members. The school age program uses Room 3 for kindergarten and 1st graders. Room 2 is for 2nd and 3rd grade and Room 1 is for 4th and 5th grade. 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 prepared on site and lunch and/or snacks are provided with at least 1 fresh fruit or vegetable serving per day. Food prep areas appear clean and sanitary. Food is properly stored and the kitchen appears free from hazards. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children via water fountains or Igloo jugs. Water is also provided by portable Igloo's during outside playtime. The children's bathrooms appear clean and sanitary. Children do not nap at the center. The facility has conducted an emergency drill within the past six months and the last one occurred on 5/13/19. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher in addition to a fire alarm system. The playground is completely fenced however the facility only uses a portion of the playground that is sectioned off for the school age children by use of cones. School age children also have access to the elementary school climbing structures which has sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Sign in/out procedure was reviewed to insure compliance. At least one staff member present possesses current CPR/First Aid certifications, which expires 10/19/19.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

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: HEIDEMAN SCHOOL AGE CDC	FACILITY NUMBER: 304270318
	VISIT DATE: 05/15/2019

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A sample of children’s files (10) were reviewed for Emergency Contact information/ health history and all files were complete. Staff files (8) were reviewed for educational credits and CPR/Pediatric First Aid.

The center does provide Incidental Medical Services (IMS) to school age children. The site also has a full time nurse on staff at the Elementary School. LPA reviewed storage of medication and 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. 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

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.

Licensee was advised on how to receive notifications for quarterly updates and was provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. Licensee was informed of where to access regulations and forms from CCLD website at: www.ccld.ca.gov. LPA provided lead brochure.
Documents/Information to be updated and returned to the Licensing Office:
1. Updated LIC 200

Exit interview was conducted. Report read out loud, reviewed and discussed. Notice of Site Visit was posted. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. 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.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

LIC809 (FAS) - (06/04)

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