304370402-8-26-2022-06-CC-MMAK-CHNU73-20220826151917

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370402
Report Date: 08/26/2022
Date Signed: 08/26/2022 03:19:25 PM

Document Has Been Signed on 08/26/2022 03:19 PM - 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:	DR. JONAS SALK SCHOOL READINESS ROOM		FACILITY NUMBER:	304370402
ADMINISTRATOR:	GONZALEZ, ROSALINDA		FACILITY TYPE:	850
ADDRESS:	1411 S. GILBERT		TELEPHONE:	(714) 527-2154
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	56	CENSUS: 0	DATE:	08/26/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Administrator/Applicant Alma Holmes		TIME COMPLETED:	04:00 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

Page 1

Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced Case Management Licensee initiated inspection for a change in capacity (decreasing capacity) along with change of classroom location. LPA met with Applicant/Administrator Ama Holmes. The Site Supervisor is Rosalinda Gonzalez. She was present on this inspection date meeting the future parents. The school is still in summer session. The school was closed on June 25th and will open Monday August 29, 2022. There were no children present at the time of this inspection. Parents and children attended the in person orientation during LPA's inspection.

Facility is currently licensed for 56 preschool age children ages 3-5 in rooms 1A, 1, B, and 3B. on Magnolia School District campus- Dr Jonas Salk School Readiness program.

Facility has requested to decrease the formerly approved capacity of 56 preschool age children to 24 preschool children in classroom 3B. Classroom (Portable). This classroom/portable (3B) has been relocated from the north side of the school ground to the south west of the school ground.

LPA and Applicant/Administrator, Ama Holmes toured the facility inside and out. The facility operates morning session from 8:00 am to 11:00 am and afternoon session from 12:00 noon to 3:00 pm.

Classroom/portable 3B was measured for indoor capacity on today's inspection.

Indoor activity space:

3B classroom/portable 39 X 23= 897 divided by 35 = 25.62 (26 children). Facility has sufficient space to accommodate 24 preschool age children in this portable.

Continued on page 2

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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: DR. JONAS SALK SCHOOL READINESS ROOM	FACILITY NUMBER: 304370402
	VISIT DATE: 08/26/2022

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

Page 2 of 3

Total sinks: 3 X 15 = 45 children / Total toilets: 2 X 15= 30 (children)
Facility has sufficient sinks and toilets to support the requested capacity of 24 preschool age children.
There are one toilet and one sink from the girls bathroom and one toilet and one sink from boys bathroom for children's use. There is one sink available in the classroom for children's use. There is a waiver on file for sharing the restroom with Kindergarten children from Elementary School.

Outdoor space: Facility is sharing a playground on this elementary ground. There is a waiver on file to share the playground with Kindergarten children from this elementary school on different scheduling.
The playground has a surrounding fence with soft cushion flooring, placed on the age appropriate toy structures with shade to absorb any falls and shade is provided by a building structure and trees. Age appropriate toys and play structures were observed in the playground.

Outside measurements: Total playground measurements
94 X 65 = 6110 square feet divided by 75 = 81 children. Facility has sufficient space to accommodate 24 preschool age children in this playground.

The following was observed in classroom/portable 3B:

· Age appropriate furniture and equipment’s
· Educational items /Arts and Crafts activities.
· Room is well lighted with ventilation.
· Drinking water is provided by children who bring their own water bottles to school.
· Facility offers breakfast to children from morning session and lunch to children from afternoon session.
· CDC Guidelines are being followed.
· Classrooms has specific age appropriate bathrooms.
Facility Site Supervisor is current on the required Pediatric CPR/First Training and will expire on 1/18/2024. Fire clearance has been granted by Orange County Fire Authority for the requested capacity of 24 children.
Review of records to be maintained : LPA reviewed the posting requirements and director's file, The were in compliance.
Continued on page 3

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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: DR. JONAS SALK SCHOOL READINESS ROOM	FACILITY NUMBER: 304370402
	VISIT DATE: 08/26/2022

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

Page 3 of 3

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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

Subscribe to CCLD important information

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Notice of Site Visit : A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit Interview : Exit interview conducted and report was reviewed with the Applicant/Administrator Ama Holmes.

No deficiency was observed on today's inspection

An updated license shall be issued, for 24 Preschool children ages 3 to 5 years old in portable 3B. Monday to Friday 8:00 am to 4:00 PM. Morning session 8:00 am to 11:00 am and afternoon session from 12:00 to 3:00 pm. Waiver to share playground and restroom with Kindergarten children. Title 5 school,

End of report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3