304370262-8-15-2023-06-CC-MMAK-CUQQSW-20230815122613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370262
Report Date: 08/15/2023
Date Signed: 08/15/2023 12:26:18 PM

Document Has Been Signed on 08/15/2023 12:26 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:	REYES, JASON		FACILITY TYPE:	850
ADDRESS:	19231 HARDING LANE		TELEPHONE:	(714) 378-2033
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY:	75	CENSUS: 0	DATE:	08/15/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Site Supervisor		TIME COMPLETED:	01:00 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	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of the facility increasing their capacity from 75 preschool children to 124 preschool children by adding rooms 9 and 12. Currently the facility has been licensed for 75 children in rooms 1, 2, 3, 4, 5, 6, 7, 10, and 13 for ages 2 to 6 years old, Monday to Friday from 7:30 am to 5:00 pm. LPA met with the Site Supervisor, Jason Reyes who gave LPA a tour of the facility. The facility is located on the ground of Perry Elementary school which is no longer in session on this premises. The facility will continue using the designated outdoor yard and the restrooms on the premises. Some classrooms have their own restrooms. There were no children present due to Summer Break. The Preschool starts 9/11/2023. The facility is running Title 5 program and operating from 9am -1pm for part time program and on a fee based program, and 9:00 am to 4:00 pm for full time program. 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 City Unified School District). The facility provides morning and afternoon snacks and parents provide lunch to children. Children nap on cots for the full time program. Beddings are provided and washed by the facility on a weekly basis. The children are dropped off and are singed in and out at the entrance manually. The facility has met all the posting requirements. If children become ill during the day, they will rest in the isolation area located, in the nurse’s office, next to the school office, away from the other children, and use the adult restroom. 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: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: 08/15/2023

NARRATIVE

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Following was observed in the rooms:
Age appropriate furniture and activities including Educational, arts & crafts items.
Room is well ventilated with proper lighting and shade.
There is a working Smoke detector and Carbon Monoxide.
Outdoor Activity Space: Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment with adequate of cushioning materials under the climbing structure, and slides. Shade is provided by building structure and trees.
Fire clearance approval has been received approving the requested capacity of 124 children.

The measurement of all the rooms are as below:
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
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 9 is: 754 square feet
Room 10 is: 806 square feet
Room 12 is: 780 square feet
Room 13 is: 859.71 square feet
Total indoor capacity: 9036.04 square feet divided by 35 = 258.17 (258 children)
Outdoor space in front of the classrooms: 20000 square feet divided 75 = 266.66 (267 children)
Continued on page 3

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: 08/15/2023

NARRATIVE

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Total of sinks: 14 X 15 = 210 children

Total of toilets: 8 X 15 = 120 children
Urinals: 4 X 5 = 20 children

This facility plans to provide 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) or (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.
LPA reviewed with applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Site Supervisor, Jason Reyes.

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.

Based on today’s measurements, the sinks and toilets availability, the request of the facility to add rooms 9 and 12 with a capacity of 124 will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required.

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: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3