304270776-4-17-2023-06-CC-MMAK-CQYR9J-20230417124936

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270776
Report Date: 04/17/2023
Date Signed: 04/17/2023 12:49:43 PM

Document Has Been Signed on 04/17/2023 12:49 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	ANAHEIM ELEMENTARY SCHOOL DISTRICT MADISON		FACILITY NUMBER:	304270776
ADMINISTRATOR:	APINDER KAUR		FACILITY TYPE:	850
ADDRESS:	1510 SOUTH NUTWOOD STREET		TELEPHONE:	(714) 517-8935
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 17	DATE:	04/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Laura Zamara		TIME COMPLETED:	01:15 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	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an onsite inspection for the purpose of an Annual Inspection and changing room. LPA met with staff in charge, Laura Zamara who was substituting for site supervisor today. The site supervisor, Kaur Apinder was out today. LPA toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. The classroom that children are currently are in is Moudle 1 which was inspected. The facility is located on Elementary School Site. There were a total of 17 preschool children with 3 staff in this classroom today. LPA also met with Lynda Durand, School Readiness Coordinator from Office of Early Childhood Education with Anaheim Elementary School District who arrived during LPA's inspection. LPA observed the facility was following CDC and Dept of Public Health Guidelines. Facility hours are 7:30am - 4:00pm. in two morning and afternoon sessions, Monday through Friday. The staff are exempt from fingerprinting because the staff are the employees with Anaheim Unified School District. (AEUSD). During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. The facility provides snacks and lunch to children. The Floors, equipment, and furniture were clean and observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by children's own water bottles. The new room that children will be moving to is in building Module 2 next to the existing classroom. LPA measured the new room. The measurements was as below: Classroom Module 2 is 23.01 X 27.7 = 637.37 and the corner is 14.7 X 11.8 = 173.46 and the total squred feet is: 810.83 divided by 35 is 23.16 (23 children) The playground will be the same one that facility is currently using. A waiver is on file for main streaming with inclusion program. Total outdoor activity space measurement is as follows: Outdoor space in front of the classrooms: 6400 square feet divided 75 sq feet = 85.33 (85 children). Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ANAHEIM ELEMENTARY SCHOOL DISTRICT MADISON	FACILITY NUMBER: 304270776
	VISIT DATE: 04/17/2023

NARRATIVE

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The classroom has two toilets for children and one sink inside the restroom. There are two sinks in the classroom. Orange county Fire authority has approved the facility for a total of 24 children in room Module 2 but the measurement is enough for 23 children.

Children do not nap in this program. The facility has a at least one carbon monoxide detector. Facility meets all posting requirements.

The outdoor activity space was inspected for compliance. The playground is enclosed by a fence at least four feet in height and is in good repair. The surface of the outdoor activity space is maintained and free of hazards. The cushioning material around outdoor play equipment and other similar equipment appeared to be enough to absorb falls. Drinking water in the outdoor activity space is provided by children's own water bottles. The outdoor equipment and toys are in good repair and free of sharp edges. There are no bodies of water present at the facility. The inspected outdoor facility grounds are safe, sanitary and in good repair.
Three staff files were reviewed for staff present during the facility inspection on this date. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a childcare facility if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for all staff were reviewed. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications.
Ten children's records were reviewed, and there was a separate, complete and current record for each child. (The files were in compliance)
For Incidental Medical Services (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.htmThe Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov Director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ANAHEIM ELEMENTARY SCHOOL DISTRICT MADISON	FACILITY NUMBER: 304270776
	VISIT DATE: 04/17/2023

NARRATIVE

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The facility was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov The site supervisor may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The facility was informed, and website given, about the California Child Care Disaster plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org
California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness . Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative. The facility has passed the lead testing for water. It was reminded the testing is required every 5 years after the first testing.
In the above areas were inspected, no deficiency was cited today.
A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Lynda Durnad.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Based on today’s indoor measurement of Module 2, playground, sinks and toilets availability, the request of the facility for moving to Module 2 for 23 children will be final reviewed and discussed with management in the Regional Office and after receiving the following. The facility will be notified if any additional information is required.
1- 25.00 check for decreasing capacity since the new room (Module 2 is enough for 23 children and the facility is currently licensed for 24 children). Lynda Durand will let LPA know of their final decision.

End of reports.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

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