<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370345
Report Date: 03/13/2020
Date Signed: 03/13/2020 11:49:30 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:HILLTOP NURSERY SCHOOLFACILITY NUMBER:
304370345
ADMINISTRATOR:ANDERSON, LYNETTEFACILITY TYPE:
850
ADDRESS:9685 WARNER AVE.TELEPHONE:
(714) 963-9838
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:46CENSUS: 12DATE:
03/13/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Anderson LynetteTIME COMPLETED:
12:00 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
An unannounced, Required-1 year inspection was conducted on this date by Licensing Program Analyst (LPA) Ketki Desai. Upon arrival, LPA was greeted by a teacher at the entrance, immediately gave access to the LPA and Director (AL) Anderson Lynette met at the open deck area of the facility. LPA explained the purpose of the inspection and a tour was taken. This facility is a play based along with parent cooperative program. There are 2 big rooms and within them are 2 classrooms each. Parents sign in manually and the clip board is kept at the entrance of the classroom area. Upon arrival today LPA observed two parent volunteers, three teachers and Administrator on site providing additional support and care.

Census: 12 children. ( Seeds room: 8 children with two teacher ( 2 days: Thursday and Friday) Sprouts rooms: No children present : 3 day program Monday Tuesday and Wednesday. Blooms rooms: No children: 4 day program Monday to Thursday. Blossoms room: 4 children with one teacher: 4 day program (Tuesday to Friday)

The Center's days and hours of operation are Mon.-Fri. 9.30 am to 1.00 PM. Parent volunteer come in little early to assist in setting up the rooms.

Posting requirements: All posting requirements were observed on the Parent Boards. The license and the snack menu are posted on the Board along with the required Licensing forms.

Physical Plant: Director guided LPA on a tour of the classrooms and the playground. (floor and yard plan were verified). Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating and air-conditioning, lighting and ventilation were evaluated. 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.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HILLTOP NURSERY SCHOOL
FACILITY NUMBER: 304370345
VISIT DATE: 03/13/2020
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
26
27
28
29
30
31
32
Poisons/Hazardous Items are stored under the sink in a locked cabinet. Storage for children's belongings and an isolation area with a sink and toilet was inspected. Ill children will remain in a classroom gathering area or with the Director. Availability of drinking water was reviewed. Classroom has a drinking fountain and during outdoor activities water pitcher with small cups is available and children also bring in their own personal water bottles. There is a carbon monoxide detector mounted on the wall and is operable.

Outdoor equipment was inspected for safety, cushioning material, good repair and age appropriateness. There is grass area and all the play equipment have sand cushioning underneath to absorb any falls. Children have also grown their own vegetable garden and there are several fruit trees. The playground is surrounded on all four sides by a four feet fence. The play area was inspected for hazards and inaccessibility to bodies of water. The toys are stored on the playground.

Food Service: Facility serves hot snacks, prepared by parent volunteer, menu is posted along with the Allergy list on the refrigerator. Snacks are served in a family style dining. Food prep areas appear clean and sanitary. Food is properly stored. Solid waste receptacles have a tight-fitting cover and are in good repair.

Health related Services: There is one First Aid Kit is classroom cabinet, review of medication policy, including administering, labeling, storage, and records was made. All medication is kept in a locked box near the first aid kit in the classroom. Director is current on the required First Aid and CPR training, which is valid through 11/24/2020

This facility provides Incidental Medical Services – IMS. information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173
101226. 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 athttp://www.ada.gov/childqanda.htm www.ada.gov/childqanda.html. Currently there are no enrolled children who receive this services.
Transportation: This facility does not provide transportation.

An Emergency Disaster Drill log is kept. The last fire drill was ran 02/18/2020.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HILLTOP NURSERY SCHOOL
FACILITY NUMBER: 304370345
VISIT DATE: 03/13/2020
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
26
27
28
29
30
31
32
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 Director 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.

A random sample of four children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day. The child is signed in and out for the person responsible for the child.
Staff files for staff present during today’s inspection were reviewed for a health screening, immunization’s and mandated reporter training. At least one staff member present possesses current CPR/First Aid certifications, which expires 11/2020. One staff and four parent files were reviewed and contained a health screening as required. Proof of immunization's against influenza (or written decline), pertussis and measles for employee and volunteers present during today’s inspection were reviewed and within compliance of SB 792. Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years, per A.B. 1207. Proof of completion as required by AB 1207 for Director, Lynette Anderson is current on the required training's and LPA reminded the Director, to renew Mandated training every two years.

In the areas that were evaluated, there were no deficiencies observed under California Code of Regulations, Title 22, Division 12 at the time of the visit. Exit interview was conducted. The report was reviewed and discussed. Appeal Rights discussed and provided to the facility Director.

The 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 $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3