304370222-2-4-2021-06-CC-STOE-BXWLKE-20210204074923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370222
Report Date: 02/03/2021
Date Signed: 02/04/2021 07:49:34 AM

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:	ANAHEIM ELEMENTARY SCHOOL DISTRICT GUINN		FACILITY NUMBER:	304370222
ADMINISTRATOR:	JELINEK, VIVIANA		FACILITY TYPE:	850
ADDRESS:	1051 S. SUNKIST STREET		TELEPHONE:	(714) 517-8550
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY:	48	CENSUS: 0	DATE:	02/03/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:51 AM
MET WITH:	Lynda Durand, School Readiness Coordinator		TIME COMPLETED:	11:30 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	A case management inspection was conducted on this date by Licensing Program Analyst (LPA) Stacy Torrence. Applicant submitted an application requesting a decrease in capacity. The purpose for today’s inspection was to evaluate the facility for decrease in capacity. Facility is currently licensed for 48 preschool children in rooms K-1 and #17 only and is requesting to decrease capacity to 24 children. LPA met with Lynda Durand, School Readiness Coordinator and toured the facility. Per Lynda Durand, the facility will no longer utilize room #17. Children are participating in virtual learning; therefore, there are no children or staff present today. The facility operates Monday-Friday, 7:30 a.m.-4:30 p.m.(AM session 8:00 a.m.-11:00 a.m. and PM session 12:30 p.m-3:30 p.m.The facility is located on the Anaheim Elementary School District James Guinn site. 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. The school nurses' office will serve as the isolation area for ill children temporarily until parents arrives. There is a designated isolated bathroom near the nurse's office. Medication will be stored in a locked cabinet in the classroom. First Aid kit is in the classroom in a cabinet. Sign in / sign out record meets regulation requirements. The facility will provide breakfast for AM session and lunch for PM session, which is provided by the school district. Evaluator reviewed Title 22 Sections 101227 and 101327 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food. Classrooms are adequately equipped with age and size appropriate furniture and equipment. Drinking water in the indoor/outdoor activity space will be supplied by water fountain.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2021

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: ANAHEIM ELEMENTARY SCHOOL DISTRICT GUINN	FACILITY NUMBER: 304370222
	VISIT DATE: 02/03/2021

NARRATIVE

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Inside Activity Space measurements are as follows:
Total indoor activity area:
Room #K-1: 1368 sqft,
Total= 1368 sqft. divided by 35 = 39 children

Total children toilets and sinks:
toilets 2 x 15= 30 children
sinks 3 x 15= 45 children

Total outdoor activity area:
8852 sqft. divided by 75 =118 children
Playground is completely enclosed by a fence. Outdoor activity area is supplied with age and size appropriate equipment including a climbing apparatus, tire swing, and slide. An adequate amount of cushioning material is in place under the equipment. Shade is provided by mature trees and metal awning.

Based on today's inspection, facility has enough space for the requested decrease capacity of 24 preschoolers (ages 3-5 years old). Monday to Friday 7:30 a.m. to 4:00 p.m.

Facility provides Incidental Medical services.

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

Facility meets all licensing requirements and file will be submitted for 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: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2021

LIC809 (FAS) - (06/04)

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