304270724-6-28-2022-06-CC-KDEI-CFTVQX-20220628163903

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270724
Report Date: 06/28/2022
Date Signed: 06/28/2022 04:40:03 PM

Document Has Been Signed on 06/28/2022 04:40 PM - It Cannot Be Edited

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:	SAUSD/KENNEDY ELEMENTARY		FACILITY NUMBER:	304270724
ADMINISTRATOR:	ORLANDO, KEELY		FACILITY TYPE:	850
ADDRESS:	1300 E. MCFADDEN		TELEPHONE:	(714) 972-5786
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92705
CAPACITY:	57	CENSUS: 0	DATE:	06/28/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Ms. Berber, Veronica Early Education Specialist		TIME COMPLETED:	04:45 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) Desai, Ketki conducted an announced Case Management Licensee initiated inspection at the above facility for the purpose of Increasing the Preschool capacity in the current licensed rooms # 101, 102 and 103. Facility is requesting to increase the capacity to 72 children. The facility is currently licensed for 57 preschool children. LPA Desai, Ketki met with Early Education Specialist Ms. Berber, Veronica who guided analyst on a tour of the facility. The facility is located on the John F Kennedy Elementary school under Santa Ana Unified School district. Due to summer break, there were no children present in any of the classrooms. Currently the facility is operating from 8.00 am to 4.00 PM, Monday to Friday serving children ages 2-5 years old. Facility has a letter from the School board approving the use of the designated classrooms and for children to use the school designated Boys and Girls bathrooms and the Play yards. Facility shall offer a full day program in Room # 101 and 102 from 8.00 am - 4.00 PM. Children attending Full day session shall be served Breakfast/ Lunch and a PM snack and napping shall be offered. All napping items are provided by the facility and the linens/blankets are taken home for wash on a weekly basis. Two half day sessions are offered in Room # 103, AM session 8-11 am where Breakfast shall be served and PM session 12.00 to 3.00 PM :lunch shall be served. There will be no napping in the half day session. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. All areas identified on the Facility Sketch were inspected. If children become ill during the day, they will rest in the isolation area located, in the nurse’s office, next to the school office, away from the other children, there is also a bathroom located in this area for the ill children to use. (1 of 2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: SAUSD/KENNEDY ELEMENTARY	FACILITY NUMBER: 304270724
	VISIT DATE: 06/28/2022

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
26
27
28
29
30
31
32

Medication will be stored in the classroom, located in a top cabinet. Incidental Medical services are provided. Furniture and equipment were inspected for age appropriateness and good repair. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. The facility provide water inside/outside by a water jug and disposal cups and children bring their own water bottles from home labeled with their names. First Aid supplies were inventoried.

Center provide breakfast / lunch and PM snacks children, which is delivered to the facility by the school district cafeteria.

Following was observed in all the three classrooms (101, 102 and 103)
1) Age appropriate furniture and activities including Educational / Arts & Crafts items.
2) Room is well ventilated with proper lighting and shade.
3) There is a working Smoke detector / Carbon Monoxide detectors and Fire Extinguisher.
4) There is one sink in each classroom and additional sinks and toilets just outside the classroom on the school premises.
5) Children shall nap on the cots, linens and blankets are provided by the facility in the full day program..
6) Parent drop off - pick up: Designated gate next to the main office. Electronic sign in using a specific Pin number and manual sign in also available.
7) There is storage room in room # 101 and this area is off limits to children.

Indoor activity space: 2373'05 divided by 35= 67'80 ( 68 children): Facility has limited indoor activity space to accommodate the requested capacity of 72 children. Based on today's indoor measurement, facility can accommodate only 68 preschool age children in the 3 assigned classrooms. (101, 102 and 103)

Total sinks : 19 X 15 = 285 children / Toilets: 17 x 15= 255 children (There are designated toilets and sinks for the preschool age children inside the bathrooms)

Outdoor Activity Space: Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment. Adequate shade is provided by Canopies and trees. The play yard shall be shared with the Kindergarten and Special Aid education program children.
(2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: SAUSD/KENNEDY ELEMENTARY	FACILITY NUMBER: 304270724
	VISIT DATE: 06/28/2022

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
26
27
28
29
30
31
32

Fire clearance approval letter on file and dated 06/23/2022, approving the requested capacity.

In the areas evaluated, no deficiency was observed and cited today per CA Code of Regulations, Title 22, and Division 12.

New License with a capacity of 68 preschool age children (2-5 years) in Room # 101, 102 and 103
Monday To Friday 8.00 am - 4.00 P .
Full day session Room # 101 and 102: 8.00 am to 4.00 PM
Half day session in Room # 103 : (AM Session : 8.00 am to 11.00 am & 12.00 PM to 3.00 PM)
Above license shall be issued upon Management approval.

Exit interview was conducted. A copy of this report and appeal rights were discussed and provided to the director. The Notice of Site Visit was posted. The director 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.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3