304370298-5-14-2020-06-CC-DVAA-BPLL7N-20200514083035

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370298
Report Date: 05/13/2020
Date Signed: 05/14/2020 08:30:39 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:	WALDORF SCHOOL OF ORANGE		FACILITY NUMBER:	304370298
ADMINISTRATOR:	WEBSTER, TERRI		FACILITY TYPE:	850
ADDRESS:	2350 CANYON DRIVE		TELEPHONE:	(949) 574-7775
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	75	CENSUS: 0	DATE:	05/13/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Jenell Carlson, Parent & Child director		TIME COMPLETED:	04:15 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	An inspection was conducted at the facility by LPA Dean Valencia. The facility file was reviewed prior to this inspection being conducted. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance. The facility has requested an increase in capacity to 85, adding a toddler option (18 months to 36 months), in a room 14. An approved fire clearance was received by Licensing on 5/12/20, approving the increase in capacity. Room 14 is being added to the facility, currently operating in Rooms, PK1, PK2, K1, and K2. Room 14 measures for 628 sq ft and has one sink inside the classroom and two toilets for toddler use in a separate restroom near the administration building. This restroom has been designated for toddler or preschool child use only. The four preschool classrooms have 10 sinks and 8 toilets available for child use. The following room measurements of the existing 4 preschool rooms were taken from a previous Licensing report: Room K1 ia approximately 1290 sq ft/35 = 36 children. Room K2 ia approximately 1290 sq ft/35 = 36 children. Room PK1 is approximately 930 sq ft/35 = 26 children. Room PK2 is approximately 960 sq ft/35 = 27 children. The Room 14 has an adjacent outdoor play area for toddler use, with sufficient space, and has age appropriate play equipment. The facility has submitted updated facility documentation for the addition of the toddler option. Operating hours of the toddler option and preschool are 8:30am to 1pm, Tues and Thurs, only. The facility was toured inside and outside and the floor and yard plan were verified. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. There were no staff or children in care as the facility is closed at this time. The facility appeared clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Children do not nap as this is a half day program. (continued on LIC809C)

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2020

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: WALDORF SCHOOL OF ORANGE	FACILITY NUMBER: 304370298
	VISIT DATE: 05/13/2020

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Food is prepared on site; snacks are provided, and lunches are brought from home. Food prep areas appear clean and sanitary, food is properly stored. The facility has a menu posted and is up to date. There is drinking water available to children both indoors and outdoors. The children's bathrooms are clean and sanitary. There is a changing table available in the toddler room. The facility has conducted an emergency drill within the past six months, and is documenting them. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The playgrounds are completely fenced and fencing is in good repair. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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
Proof of immunization's against pertussis, influenza (or written declination), and measles for all employees/volunteers are on file and within compliance. All licensing reports are public information and must be made available upon request. This report was reviewed and discussed with the the care provider. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
The facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. and accessibility and access to the website was discussed with the care provider. This report is to be on file and accessible for public review at the facility for at least 3 years.

The increase in capacity to 85 has been approved, pending a managerial review.

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

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2020

LIC809 (FAS) - (06/04)

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