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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370327
Report Date: 10/08/2019
Date Signed: 10/08/2019 10:03:20 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:EVERBROOK ACADEMYFACILITY NUMBER:
304370327
ADMINISTRATOR:LARSON, RUTHFACILITY TYPE:
850
ADDRESS:30722 RICHARD REESE WAYTELEPHONE:
(949) 888-7274
CITY:RANCHO SAN MARGARITASTATE: CAZIP CODE:
92688
CAPACITY:105CENSUS: 54DATE:
10/08/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Assistant director, and directorTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of this facility for the purpose of increasing the preschool capacity from 105 children to 117 preschool children. LPA met with assistant director, Kim San Jose. The director, Ruth Larson arrived during LPA's inspection. Census was taken. There were a total of 54 preschool children with 6 staff in four different classrooms. A review of staff records on today's date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Five classrooms were measured today.
1- Preschool Room approximately 1215 square feet with 2 toilets and 3 sinks.
2- Pre Kindergarten room approximately 1204 square feet with 2 toilets and 3 sinks
3- Junior Kindergarten room approximately 832 square feet with 2 toilets and 5 sinks
4- Two year old room approximately 825 square feet with 2 toilets and 5 sinks
5- The Brook room (Indoor gym) approximately 693 square feet with 2 toilets and one sink.
Total indoor capacity is measured 4769 divided by 35 square feet per child is 136 children with total of 10 toilets and 17 sinks for total of five above rooms.
Outdoor space were measured.
Preschool yard 1 is approximately measured 8580 square feet
Preschool yard 2 is approximately measured 5538 square feet
Total outdoor space for preschool is approximately 14118 divided by 75 square feet per child is 188 children.
The Notice of Site Visit was posted. 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. The licensee was provided a copy of their appeal right (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.
Exit interview was conducted.
An updated license for a capacity of 117 preschool children is issued today.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019
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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