304370288-9-4-2024-06-CC-CNGN-D8SNTH-20240904104445

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370288
Report Date: 09/04/2024
Date Signed: 09/04/2024 10:44:50 AM

Document Has Been Signed on 09/04/2024 10:44 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	WESTMINSTER SCHOOL DISTRICT-CLEGG PRESCHOOL		FACILITY NUMBER:	304370288
ADMINISTRATOR/ DIRECTOR:	JENNIFER WOJTKIEWICZ		FACILITY TYPE:	850
ADDRESS:	6311 LARCHWOOD DRIVE		TELEPHONE:	(714) 894-7218
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92647
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/04/2024
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Program Supervisor, Michelle Miller		TIME VISIT/ INSPECTION COMPLETED:	11:00 AM

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Licensing Program Analyst, (LPA) Cindy Nguyen conducted a case management inspection on this day for the purpose of reinstating the license from inactive to active status. LPA met with Program Supervisor, Michelle Miller. There were no children present during the inspection.

Operating hours are 7:00 AM to 5:00 PM, Monday through Friday. This is a full day program operated by the Westminster School District. This facility is located on the campus of Clegg Elementary School Room A1. The facility was toured inside and outside, and the floor and yard plan were verified. The facility representative stated there is no bodies of water on site. LPA confirmed with facility representative that firearms/weapons are not allowed or stored on premises. 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. 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. 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, lose or pointed parts. Breakfast, lunch and snacks are provided for the full day program. There is drinking water available to children both indoors and outdoors. The facility has a working smoke detector, and fire extinguisher that meet statutory requirements.

There is a waiver on file to co-share the outdoor playground with the elementary school on a rotating basis. The playground was completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. There is sufficient wood chips cushioning underneath climbing structures and/or play equipment to absorb falls.

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024

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: WESTMINSTER SCHOOL DISTRICT-CLEGG PRESCHOOL	FACILITY NUMBER: 304370288
	VISIT DATE: 09/04/2024

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

Facility representative was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. A copy of the Department of Social Services Lead Information brochure was given to the director.

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 representative 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.

There were no Title 22 deficiencies cited during today's inspection

Documents/Information to be updated and returned to the Licensing Office before license will be activated.

· Complete Director Package

· Application for a Child Care Center License (LIC 200A)
· Emergency Disaster Plan (LIC 610)
· Facility Sketch (LIC 999)
· Personnel Report (LIC 500)
· Parent Handbook
· Picture/Video of a working Carbon Monoxide Detector
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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024

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: WESTMINSTER SCHOOL DISTRICT-CLEGG PRESCHOOL	FACILITY NUMBER: 304370288
	VISIT DATE: 09/04/2024

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Exit interview was conducted with Program Supervisor, Michelle Miller. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Facility representative 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. Appeal rights provided and explained. The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. Facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024

LIC809 (FAS) - (06/04)

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