304370150-8-17-2023-06-CC-GLUO-CUSPRK-20230817113251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370150
Report Date: 08/17/2023
Date Signed: 08/17/2023 11:32:56 AM

Document Has Been Signed on 08/17/2023 11:32 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:	NOBIS PRESCHOOL		FACILITY NUMBER:	304370150
ADMINISTRATOR:	MELINDA MARCHESE		FACILITY TYPE:	830
ADDRESS:	190 EAST 15TH STREET		TELEPHONE:	(949) 548-2550
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	16	CENSUS: 11	DATE:	08/17/2023
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Director Melinda Marchese		TIME COMPLETED:	11:45 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) On 08/17/2023 Licensing Program Analyst (LPA) Lucero conducted an unannounced Case Management to ensure that the facility is staying within compliance of Title 22 regulations. LPA met with Director Melinda Marchese. LPA took census in the infant classrooms. There were 11 infants with 4 staff members in the infant class. The facility was operating within its licensed capacity and within compliance of staff-to-child ratios. An on-site Facility Personnel Report Summary review showed that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions. During the inspection of the indoor activity space, LPA did not observe any items which could pose a danger to children (poisons, detergents, cleaning compounds, medications or hazardous items). All storage containers for solid waste, including moveable bins, have tight fitting covers that are kept on, and are in good repair. Bottles, dishes and containers of food brought by the infant’s authorized representative are labeled with the infant’s name and current date. The facility has age appropriate furniture and equipment including, but no limited to, cribs or mats, changing table and feeding chairs. A baby walker was not observed during today’s visit. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. LPA conducted a facility inspection of the napping area. LPA observed staff were implementing safe sleep regulations, there were no items inside the cribs only a crib sheet. LPA reviewed the napping log. Staff files were reviewed for staff present during the facility inspection on this date, 5 out of 5 staff files were reviewed. Health screening and immunizations as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a childcare center if he or she has not been immunized against influenza, pertussis, and measles. 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. (continue to page 2)

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Giselle Lucero	TELEPHONE: 714-292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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: NOBIS PRESCHOOL	FACILITY NUMBER: 304370150
	VISIT DATE: 08/17/2023

NARRATIVE

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(page 2)
Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 5 of children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700), Immunization records, Consent for Emergency Medical Treatment (LIC627), Notification of Parent’s Rights (LIC995A), medical assessment and found to be in compliance. LPA observed and reviewed LIC 9227 Individual Infant Sleeping Plan and Needs and Services Plan in children’s files. In the areas reviewed the children’s files were found to be in full compliance.

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.

LPA went over personal rights and safe sleep regulations with Director.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The LPA conducted an exit interview and reviewed the report with Director Melinda Marchese. The “Notice of Site Visit” was posted, and the licensee is aware that it shall remain posted for 30 days. The Appeal Rights were explained. The licensee received a copy of the Appeal Rights (LIC 9058 01/16), their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First-level appeals should be sent to the Regional Manager to the address listed above.

End of Report.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Giselle Lucero	TELEPHONE: 714-292-2922
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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