304370550-9-3-2019-06-CC-YVIA-BFNUZ3-20190903160053

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370550
Report Date: 09/03/2019
Date Signed: 09/03/2019 04:00:58 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:	OC KIDS CHILDCARE INC.-LANDELL		FACILITY NUMBER:	304370550
ADMINISTRATOR:	KARISSA DEGENER		FACILITY TYPE:	840
ADDRESS:	9705 DENNI STREET		TELEPHONE:	(714) 229-9281
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY:	112	CENSUS: 7	DATE:	09/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Casie Hollenbeck, Licensee		TIME COMPLETED:	04:15 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	Licensing Program Analyst (LPA), Villa conducted an unannounced annual/random inspection of the facility on today's date. LPA Villa toured the facility with the Licensee, Casie Hollenbeck inside and outside. Census was taken in individual classrooms. The overall census observed were 7 school age children present with two teachers. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Operating hours are 6:00 PM- 6:00 pm, Mon-Fri offering before and after school care. The facility is located at Landell Elementary School in room number B and C. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Per license they offer PM. snacks for the children. A menu was observed to be posted and available for 30 days. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children both indoors and outdoors. The children's bathrooms are clean and sanitary. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The children use the elementary school playground it was observed to be completely fenced. The playground equipment appeared in safe condition. There is enough cushioning underneath climbing structures and/or play equipment to absorb falls. Sign in/out procedure was reviewed for compliance. During today's visit staffing ratios were being met. At least one staff member present possesses current CPR/First Aid certifications, which expires 02/21/2021. Children's and staff files were reviewed for compliance. Children's and staff files were in compliance.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

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.-LANDELL	FACILITY NUMBER: 304370550
	VISIT DATE: 09/03/2019

NARRATIVE

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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

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.

Proof of immunization's against pertussis and measles for all employees/volunteers were reviewed for compliance with SB 792.

Facility was advised on how to receive notifications for quarterly updates and provided department web site www.cdss.ca.gov.

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

Exit interview was conducted with Licensee Casie Hollenbeck. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Appeal Rights and deficiencies were discussed. The director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

The director 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. The “Notice of Site Visit” must be posted on or adjacent to the door.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC809 (FAS) - (06/04)

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