304370262-3-7-2023-06-CC-MMAK-CPPUA8-20230307142417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370262
Report Date: 03/01/2023
Date Signed: 03/07/2023 02:24:52 PM

Document Has Been Signed on 03/07/2023 02:24 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:	HBCSD-PRESCHOOL ACADEMY		FACILITY NUMBER:	304370262
ADMINISTRATOR:	WERTHEIM, CAROLYN		FACILITY TYPE:	850
ADDRESS:	19231 HARDING LANE		TELEPHONE:	(714) 378-2033
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY:	75	CENSUS: 0	DATE:	03/01/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Director		TIME COMPLETED:	03:15 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 2 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of adding room # 10 to the existing rooms without changing the capacity. LPA met with new applicant/site supervisor, Jason Reyes. Jason Reyes is the site supervisor for this site only. The other State Preschool Sites have their own site supervisors. Currently the facility is licensed for 75 children in rooms 1, 2, 3, 4, 5, 6, 7, and 13. The Applicant has requested to provide care and supervision for 75 preschool children in the above rooms and adding new room # 10 for ages 2 to 6 years old, Monday through Friday, 7:30 a.m. to 5:00 p.m. Since the Perry Elementary school is no longer in session on these premises. The facility will continue using the designated outdoor yard and the restrooms on the premises. Some classrooms have their own restrooms. Currently the facility operates from 9am -1pm on a fee based program, and 9:15 am to 12:15 pm for the State funded program. There were no children present at the time of inspection. 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 Huntington Beach School District) The 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 1 (Small area) = 90.61 square feet Room 1(Big area) is: 1003. 98 square feet Room 2(Small area) is: 90.18 square feet Room 2 (Big area) is: 1007.81 square feet 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: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

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: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370262
	VISIT DATE: 03/01/2023

NARRATIVE

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Room 3 (Small area) 99.92 square feet
Room 3 (Big area) 1038.93 square feet
Room 4 is: 879.87 square feet
Room 5 is: 874.49 square feet
Room 6 is: 877.26 square feet
Room 7 is: 877.26 square feet
Room 10 is: 806 square feet
Room 13 is: 859.71 square feet
Total indoor capacity: 7502.04 square feet divided by 35 = 214.34 (214 children)
Total outdoor activity space measurement is as follows:
Outdoor space in front of the classrooms: 20000 square feet divided 75 = 266.66 (267 children)
Total of sinks: 14 X 15 = 210 children
Total of toilets: 8 X 15 = 120 children
Urinals: 4 X 5 = 20 children
The classrooms are equipped with carbon monoxide detector.
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 approved the requested capacity of 75 preschool children by adding room # 10 and is on file. Based on today’s measurements, the sinks and toilets availability, the request of the facility for adding room # 10 with a capacity of 75 children 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: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

LIC809 (FAS) - (06/04)

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