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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370547
Report Date: 02/20/2020
Date Signed: 02/20/2020 10:33:36 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:SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAMFACILITY NUMBER:
304370547
ADMINISTRATOR:MEDRANO, PATRICIAFACILITY TYPE:
850
ADDRESS:1405 FRENCH STREETTELEPHONE:
(714) 564-2200
CITY:SANTA ANASTATE: CAZIP CODE:
92701
CAPACITY:48CENSUS: 37DATE:
02/20/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Patricia MedranoTIME COMPLETED:
10:45 AM
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The purpose of this visit was to conduct a follow up case management visit to the facility due to an unusual incident that was self reported to the department on 1/24/20. According to the self reported incident , a parent reported to staff that a preschool staff violated the child's personal rights. Licensing Program Analyst (LPA) Hawkins met with Lead Teacher, Patricia Medrano at the time of the visit. LPA toured the facility inside and outside. Census was taken. There was a total of 37 preschool children with 6 staff in rooms 30 and 31. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. (The staff are employees of Santa Ana Unified School District).

During today's visit LPA interviewed 1 teacher in Room 30. The allege victim no longer attends the school and was not available for interview. After interviewing 7 preschool staff, 5 preschool children, 1 parent, and reviewing records, LPA was unable to determine if the child's personal rights were violated by preschool staff.
The facility is within compliance during today's inspection.

Exit interview was conducted with lead teacher. 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. The representative was provided a copy of their appeal right (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. This report is to be on file and accessible for public review at the facility for at least 3 years.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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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