304370358-8-1-2019-06-CC-SHAS-BEMMV4-20190801095607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370358
Report Date: 08/01/2019
Date Signed: 08/01/2019 09:56:28 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:	TUSD/KINDERGARTEN READINESS ACADEMY-HEIDEMAN		FACILITY NUMBER:	304370358
ADMINISTRATOR:	TORRES, ANA		FACILITY TYPE:	850
ADDRESS:	15571 WILLIAMS STREET		TELEPHONE:	(714) 730-7521
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	24	CENSUS:	DATE:	08/01/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Emily Daniel		TIME COMPLETED:	10:15 AM

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	Licensing Program Analyst (LPA) Hawkins conducted an on site inspection for an increase in capacity. LPA met with Emily Daniel, Preschool Specialist, and toured center. An applicant has requested an increase in capacity from 24 to 48 preschool children by adding an additional classroom (#4) and bathroom. Care and supervision will be for preschool children 3 to 5 years of age, Monday through Friday, 8:30 AM - 11:30 AM; and 12:15PM- 3:15 PM. The school will be closed for the summer months of June and July. Office is located in the front of the building and will serve as the isolation area for ill children temporarily until parents arrive. The staff bathroom will be used as the isolation bathroom and is conveniently located to the isolation area. First Aid kit will be kept in the classroom. Sign-in/out will be done at the front gate by staff when the parents arrive. The children are walked back to the classroom as a group. Classrooms are adequately equipped with age and size appropriate furniture and equipment. Drinking water in the indoor activity space will be supplied by a fountain. Center policy is that AM/PM breakfast/lunch are provided by the center. Evaluator reviewed Title 22 Sections 101227 and 101327 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food. The inside activity area was measured and the findings are as follows: 1994 sqft divided by 35 = 56 children Rm#4 (997 sqft) Rm#5 (997 sqft) Bathrooms: children's bathrooms consist of Total children toilets and sinks: toilets 5 X 15 = 75 children sinks 8 X 15 = 120 children

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

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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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: TUSD/KINDERGARTEN READINESS ACADEMY-HEIDEMAN	FACILITY NUMBER: 304370358
	VISIT DATE: 08/01/2019

NARRATIVE

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The outside activity area was measured and the findings are as follows:
5292 sqft divided by 75 = 70 children.

Playground is completely enclosed by a fence. Outdoor activity area is supplied with age and size appropriate equipment including swings and climbing stricture. An adequate amount of cushioning material is in place under the equipment. Shade is provided by an overhead from the building. Fountains provide drinking water.

The yard will be shared with the kindergarten children on a rotating basis. A waiver request has been submitted.

Limiting factor for capacity is the inside activity area. Upon review and approval of a licensing manager a license will be issued for the capacity of 48.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) 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.

The facility representative was informed that the CRIMINAL RECORD STATEMENT (LIC 508) has been updated, and the facility must now use the new form with revised date 7/15. The facility representative was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Transfer Request (LIC9182). The facility representative was informed that Licensing Updates are available at www.ccld.ca.gov

THE FACILITY REPRESENTATIVE WAS INFORMED THAT THE 'NOTICE OF SITE VISIT' MUST BE POSTED FOR 30 CONSECUTIVE DAYS FOR ANY TYPE A VIOLATION. THE 'NOTICE OF SITE VISIT' WAS POSTED ON THE DOOR.

THIS REPORT IS TO BE ON FILE AND ACCESSIBLE FOR PUBLIC REVIEW AT THE FACILITY FOR AT LEAST THREE YEARS.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019

LIC809 (FAS) - (06/04)

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