304270601-5-15-2019-06-CC-SHAS-BC7QZS-20190515123714

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270601
Report Date: 05/15/2019
Date Signed: 05/15/2019 12:37:22 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 STATE PRESCHOOL CDC		FACILITY NUMBER:	304270601
ADMINISTRATOR:	SCIORTINO, DAN		FACILITY TYPE:	850
ADDRESS:	15571 WILLIAMS STREET		TELEPHONE:	(714) 834-0441
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	24	CENSUS: 22	DATE:	05/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Dan Sciortino		TIME COMPLETED:	10:30 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	Licensed Program Analyst (LPA) Hawkins arrived unannounced to 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. Census was taken. LPA observed 20 preschool children with 4 staff members on the playground, and observed school nurses (2) conducting hearing and vision screenings on 2 preschool children while preschool staff provided supervision of children who were being screened in the preschool classroom. 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 and/or are locked. Breakfast is prepared on site. 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 inside of a cooler and when the children go outside to play the cooler is brought outside. 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 5/6/2019. The facility has a working smoke detector, carbon monoxide detector and fire extinguisher along with a smoke alarm system. The playground is completely fenced. The playground equipment appeared in good condition and safe for the children. There appears to be sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Each morning staff sweep and scan the outdoor play area for any dangerous items to insure the safety of the children. Sign in/out procedure was reviewed for full legal signatures of each authorized representative and the time of day is recorded. LPA received from Dan updated copies of the LIC 500; LIC 308. Continued on page 2

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 STATE PRESCHOOL CDC	FACILITY NUMBER: 304270601
	VISIT DATE: 05/15/2019

NARRATIVE

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At least one staff member present possesses current CPR/First Aid certifications, which expires 10/2019.
A sample of children’s files were reviewed for a signed Emergency Information form and files were complete. A sample of staff files were reviewed for educational credits, and CPR/First Aid certification and files were complete.

The center does provide Incidental Medical Services and at this time there are no preschool children enrolled that take medication. The site also has a full time nurse on staff at the Elementary School. Incidental Medical Services (IMS) policy was discussed. 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

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 .Licensee was provided with 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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