304370262-2-19-2020-06-CC-KDEI-BLXR54-20200219114231

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370262
Report Date: 02/19/2020
Date Signed: 02/19/2020 11:42:45 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:	HBCSD-PRESCHOOL ACADEMY		FACILITY NUMBER:	304370262
ADMINISTRATOR:	RENEE POLK		FACILITY TYPE:	850
ADDRESS:	19231 HARDING LANE		TELEPHONE:	(714) 962-3348
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY:	72	CENSUS: 53	DATE:	02/19/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Carolyn Wertheim ( Director)		TIME COMPLETED:	12:00 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), Ketki Desai conducted an on-site inspection for the purpose of a required 1 year inspection. LPA and Director Carolyn Wertheim toured the facility inside and outside, floor and yard plan (LIC 999) were verified. The facility file was reviewed prior to this inspection. Criminal record and child abuse clearances for school district employees is monitored by the Department of Education. This facility has elected to obtain criminal record clearance through the licensing system, a review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance. There are three classrooms on this school campus of Joseph R. Perry Elementary School. Operating hours are as follows: State Preschool ( Room # 7 & 11) 9.15 am to 12.15 PM. Preschool : Room # K1 : 9.00 to 1.00 PM. During summer times the operating hours are from 8.45 to 3.30 PM. A new LIC 200 A was obtained today to reflect the operating hours. Census observed : room # 11: 19 children with 3 staff/ room # 7: 21 children with 3 staff and Room #1(K1) had 13 children with 2 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The facility appeared clean and orderly. The items which could pose a danger to children (disinfectants and cleaning solutions) were stored out of the reach of children. The director stated poisons/hazardous items are not stored on site and none were observed during today's inspection. All materials and surfaces accessible to children are toxic free. Medications are in a safe place inaccessible to children. The children’s bathrooms were observed to be in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Food is prepared by the school's nutrition services; snacks are provided. Food prep areas appear clean and sanitary. Food is properly stored. Solid waste receptacles have a tight-fitting cover and are in good repair.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

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: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370262
	VISIT DATE: 02/19/2020

NARRATIVE

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There is drinking water available to children, via water fountains in each classroom, as well as personalized water bottles. The children's bathrooms are clean and sanitary with age appropriate toilet stalls and sink . Room # 1 has an attached bathroom with one stall and 2 sinks while children in Room # 7 & 11 use the school restroom. There is a Waiver approved to share the restroom and the play yard with Kindergarden children.

The facility has conducted an emergency drill within the past month (1/15/2020). The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility office .

Staff files were reviewed present during the facility inspection this date, Six staff files were reviewed. Health screening and immunization's 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 Child Care center day care if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for (staff) were reviewed and within compliance.

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, Opener: expires in 07/ 2021. All staff are current with CPR training.

Facility Director was informed that the Criminal Record Statement (LIC 508) has been
updated, and the facility must now use the new form with revised date 7/15. Facility Director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance.

Six Children's records were reviewed, and there was a separate, complete and current record for each child. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed, each classroom has a sign in out sheet placed at the entrance of the classroom . Each classroom also ensures there on going head counts of the children along with ongoing visual supervision.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

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: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370262
	VISIT DATE: 02/19/2020

NARRATIVE

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This facility provides Incidental Medical Services - (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For 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.htm.

IMS medications are stored in a locked cabinet in the classroom locked cabinet and are administered per medical orders and log is maintained. Staff are trained through school Medical Nurse who also overseas the administration and dispensing of the medication per medical orders. Emergency medications are stored in the classrooms Emergency kit ( Red bag)
Classroom corner is used as an Isolation area for the child, additional staff is present to provide support and school readiness nurse is also available if needed.

The outdoor activity space was inspected for compliance. The yard is shared in between the classrooms and their is waiver in place. Play yard, was observed to be safe with appropriate fencing, required shade and age appropriate toys. Water fountain is accessible to the preschoolers. The surface of the outdoor activity space was well maintained and free of hazards. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility.

The cushioning material rubber foam, around the climbing equipment, slides and other similar equipment appeared to be safe enough to absorbs falls

Drinking water in the outdoor activity space is provided by Water fountain.

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 Director 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 A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

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: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370262
	VISIT DATE: 02/19/2020

NARRATIVE

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In the areas that were evaluated, no deficiency were observed under California Code of Regulations, Title 22, Division 12 at the time of the visit.

An exit interview was completed with Facility Director The report was reviewed and discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

LIC809 (FAS) - (06/04)

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