304370454-7-14-2022-06-CC-DTHN-CGBPF4-20220714111608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370454
Report Date: 07/14/2022
Date Signed: 07/14/2022 11:16:23 AM

Document Has Been Signed on 07/14/2022 11:16 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CLUB J		FACILITY NUMBER:	304370454
ADMINISTRATOR:	MARTIN, AUDRA		FACILITY TYPE:	840
ADDRESS:	1 FEDERATION WAY, SUITE #200		TELEPHONE:	(949) 435-3400
CITY:	IRVINE	STATE: CA	ZIP CODE:	92603
CAPACITY:	75	CENSUS: 0	DATE:	07/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Hilaria Duran		TIME COMPLETED:	11:45 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	On July 14, 2022 at 8:45 AM, Licensing Program Analysts (LPA) Dean Thompson conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with office Manager Hilaria Duran and advised the purpose of the inspection. Office Manager provided LPA a tour of the facility inside and out. There were zero children in care at the time of the inspection. Club J is a School age program and the hours of operation are Monday through Friday, 1:30 PM to 5:45 PM. LPA observed required licensing documents mounted on the wall inside the game room. Last fire drill was conducted in May 2022. Facility provides two PM snacks. Each of the rooms have age-appropriate toys, activities and furniture readily accessible for children when in care. LPA observed enough restrooms available for children to use. LPA did not observe any hazards/toxins items accessible to children. First Aid kits were observed throughout the facility. Facility provides afternoon snacks The outdoor area is shaded and has an ample amount of space. There is a pool at the facility that is used for summer camp only and not during Club J normal business hours. A sampling of children and staff records were reviewed. LPA observed children's files to be complete and current. LPA observed staff files to be complete and current. CPR current with an expiration date of 8/2022. Staff mandated reporter certification are all current. Office Manager was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Facility is currently following Covid-19 guidelines. LPA observed staff wearing face masks and sanitizer throughout the facility . Continued on 809-C

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0807
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CLUB J	FACILITY NUMBER: 304370454
	VISIT DATE: 07/14/2022

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Incidental Medical Services (IMS) policy was discussed. 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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Office Manager was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test.

No deficiencies were cited during todays inspection.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights were given, and report was reviewed with Office Manager Hilaria Duran.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0807
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022

LIC809 (FAS) - (06/04)

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