304370444-5-1-2019-06-CC-YVIA-BBRQ3M-20190501114859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370444
Report Date: 05/01/2019
Date Signed: 05/01/2019 11:49:05 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:	OC KIDS CHILDCARE INC.- CAWTHON		FACILITY NUMBER:	304370444
ADMINISTRATOR:	HOLLENBECK, CASIE		FACILITY TYPE:	850
ADDRESS:	10160 DENNI STREET		TELEPHONE:	(714) 484-7844
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY:	71	CENSUS: 49	DATE:	05/01/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	07:40 AM
MET WITH:	Amy Diaz, Assistant Director		TIME 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 annual inspection was conducted at the facility by Licensing Program Analyst Yesenia Villa (LPA). A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance. Operating hours are 6:00 AM to 6:00 PM, Monday through Friday. This program is composed of 3 classrooms. Upon arrival LPA met with Assistant Director, Amy Diaz who guided LPA on a tour of the facility. Karissa Degener and Casie Hollenbeck, Owners arrived during the inspection. Census was taken there were 49 children present with 7 teachers present upon arrival. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The facility was toured inside and outside and the floor and yard plan were verified. 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. All materials and surfaces accessible to children are toxic free. Medications are in a safe place inaccessible to children. The children’s bathrooms were observed to be in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Food is prepared on site; snacks are provided by the facility and lunch is brought from home by the children. Food prep areas appear clean and sanitary. Food is properly stored. Solid waste receptacles have a tight-fitting cover and are in good repair. Children nap on cots/mats, and bedding is sent home weekly to be laundered by parents.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

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: OC KIDS CHILDCARE INC.- CAWTHON	FACILITY NUMBER: 304370444
	VISIT DATE: 05/01/2019

NARRATIVE

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There is drinking water available to children both indoors and outdoors. A current menu is posted in a prominent location viewable by an authorized representative. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher that meet statutory requirements.

The playground was completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. There is enough rubber cushioning underneath climbing structures and/or play equipment to absorb falls. The facility has conducted an emergency drill on within the past six months.

A random sample of eight 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 substantial compliance. Sign in and Sign out sheets were reviewed and all children present were signed in.

Staff files for staff present during today’s inspection were reviewed for a health screening, immunization’s and mandated reporter training. All personnel files were complete and verified.

At least one staff member present possesses current Pediatrics CPR/First Aid certifications. Eight staff files were reviewed and contained a health screening as required. Proof of immunization's against influenza (or written decline), pertussis and measles for employees 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 was observed in staff files.

This facility provides Incidental Medical Services -IMS. LPA reviewed storage of medication, equipment/supplies, and reviewed children's, personnel, and administrative records. 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

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

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: OC KIDS CHILDCARE INC.- CAWTHON	FACILITY NUMBER: 304370444
	VISIT DATE: 05/01/2019

NARRATIVE

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Facility representative was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. A copy of the Department of Social Services Lead Information brochure was given to the director.

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

Exit interview was conducted with Assistant Director, Amy Diaz. Report reviewed and discussed. Notice of Site Visit was posted during the visit. 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. Appeal rights provided and explained. The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. Facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

LIC809 (FAS) - (06/04)

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