304370547-5-22-2019-06-CC-SHAS-BCETDA-20190522143801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370547
Report Date: 05/22/2019
Date Signed: 05/22/2019 02:38:10 PM

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:	SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM		FACILITY NUMBER:	304370547
ADMINISTRATOR:	GONZALEZ, NEIDA		FACILITY TYPE:	850
ADDRESS:	1405 FRENCH STREET		TELEPHONE:	(714) 564-2200
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92701
CAPACITY:	48	CENSUS: 32	DATE:	05/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Laura Barnett		TIME COMPLETED:	03:00 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	Licensed Program Analyst (LPA) Hawkins made an unannounced visit to the facility for the purpose of conducting an Annual/Random inspection. LPA met with Laura Barnett, Early Learning Specialist and toured the facility inside and outside. Santa Ana Unified School District manages the review for all staff or individuals who require caregiver background checks and that each staff/volunteer have received a criminal record clearance or exemption and a child abuse index clearance according to district policy. The center has 1 class (RM 30) that is full day from 8 AM to 4 PM. The center also offers two half day classes (RM 31) from 8 AM to 11 AM and then 12 PM to 3 PM. Census was taken and LPA observed 32 preschool children with 6 preschool staff. During the inspection it was determined that the facility is operating within its licensed capacity and within compliance of staffing ratios. The center has a waiver for a capacity waiver and restroom waiver on file in the licensing office. The items which could pose a danger to children (detergents, cleaning compounds) were stored out of the reach of children. Poisons/Hazardous Items are kept locked in the janitors closet. Food is prepared on site; breakfast, lunch and snacks are provided. Food prep areas appear clean and sanitary. Food is prepared by district cafeteria. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children both indoors and outdoors via water fountains. The children's restrooms were clean. Full day children nap on cots and bedding is taken home weekly to be washed by parents. The facility has conducted an emergency drill within the past six months and the last one occurred on 03/28/19. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The playground was completely fenced. The playground equipment appeared in good condition. There appears to be sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Continued on page 2

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

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 2

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: SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM	FACILITY NUMBER: 304370547
	VISIT DATE: 05/22/2019

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
Sign in/out book was reviewed for authorized representative signature and documented time of drop off and/or pick up. At least one staff member present possesses current CPR/First Aid certifications, which expires 2/6/21. A sample of children’s files were reviewed for authorized representative information. A sample of staff files were reviewed for educational units and immunization's.

Documents/Information to be updated and returned to the Licensing Office
- Personnel Report (LIC 500)
- Fire Drill Log

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and 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. 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

Licensee was advised on how to receive notifications for quarterly updates and was provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. Licensee was informed of where to access regulations and forms from CCLD website at: www.ccld.ca.gov
A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was observed and reviewed with the facility representative.
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Exit interview was conducted. Report read out loud, reviewed and discussed. Notice of Site Visit was posted. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. 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.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2