304370134-4-18-2023-06-CC-MMAK-CQZNLZ-20230418103421

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370134
Report Date: 04/18/2023
Date Signed: 04/18/2023 10:34:26 AM

Document Has Been Signed on 04/18/2023 10:34 AM - 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:	HIDDEN HILLS ELEMENTARY		FACILITY NUMBER:	304370134
ADMINISTRATOR:	FLOTHO, LISA		FACILITY TYPE:	850
ADDRESS:	25142 HIDDEN HILLS ROAD		TELEPHONE:	(949) 495-0050
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	48	CENSUS: 14	DATE:	04/18/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Site Supervisor		TIME COMPLETED:	11:00 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	Page 1 of 2 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of decreasing capacity from 48 preschool children to 24 preschool children by taking off room P4 off the capacity. LPA met with Site Supervisor, Lisa Flotho. Census was taken. The licensee has requested to provide care and supervision for 24 preschool children in room 6 and 7 which are connected and count as one room, ages 3 to 5 years old, Monday through Friday, 8:00 a.m. to 3:00 p.m. for two sessions of morning and afternoon. Today the total census were 14 preschool children with 2 staff including Site Supervisor. A review of the Facility Personnel Report Summary 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 or exemptions. (The staff are employees of Capistrano Unified School District and they are exempt of fingerprinting). The State Preschool is a Title 5 Program that offers two morning and afternoon sessions. Morning hours are from 8:00 am to 11:00 am and afternoon session is from 12:00 noon to 3:00 pm. The facility provides morning snack and afternoon lunch to children. Children do not nap in this program. Children are dropped off and are singed in and out at the entrance door. The facility has met all the posting requirements. The indoor activity space measurement for the current requested capacity is as follows: Room 6 and 7 combined (one room only) is 39 X 30.07= 1172.73 divided by 35 square feet 33.50 (33 children). The State Preschool shares the playground with other program on different scheduling, Continued on page 2

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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

FACILITY NAME: HIDDEN HILLS ELEMENTARY	FACILITY NUMBER: 304370134
	VISIT DATE: 04/18/2023

NARRATIVE

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There are 4 toilets and three sinks in the girl's bathroom and there in 2 toilets, 2 urinals, and 3 sinks in the boy's bathroom that this facility shares with elementary children.

The classroom is equipped with carbon monoxide detector.
Staffs' files were reviewed and they were in compliance. CPR and 1st aid for the Site Supervisor expires 1/18/2024.

Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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
Orange county Fire authority has previously approved 48 preschool children in rooms 6/7 and P4 and is on file.
Based on today’s measurements, the sinks and toilets availability, the request of the facility for decreasing the capacity to 24 children in room 6/7 (one room only) will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

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 applicant on file, Lynda Durand.

End of report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC809 (FAS) - (06/04)

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