304370632-6-8-2023-06-CC-MMAK-CSM3K6-20230608181836

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370632
Report Date: 06/08/2023
Date Signed: 06/08/2023 06:20:05 PM

Document Has Been Signed on 06/08/2023 06:20 PM - 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:	OC KIDS CHILDCARE INC.		FACILITY NUMBER:	304370632
ADMINISTRATOR:	DIAZ, AMY		FACILITY TYPE:	830
ADDRESS:	10160 DENNI STREET		TELEPHONE:	(714) 484-7844
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY:	10	CENSUS: 8	DATE:	06/08/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Licensees		TIME COMPLETED:	11:30 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	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of increasing capacity by moving from the current infant room in Building C to preschool building in Room A. The current infant room in Building C will no longer be on the license. LPA met with licensees, Casie Hollenbeck, Karissa Degener, and director, Amy Diaz who gave a tour of the school to LPA. Currently the facility is licensed for 10 infants and toddles ages 6 weeks old to 24 months old in Building C. LPA observed there were 3 staff with 8 children in this room. The facility is located on a School District Ground. The school is not in operation for Public School Elementary Children. A review of the Facility Personnel Report Summary 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. The facility has requested to provide care and supervision to 20 infants and toddlers ages 6 weeks old to 24 months old in Room A , Monday to Friday from 6:00 am to 6:00 pm. The children are dropped off, signed in and out manually. They entered the facility through the entrance of the building leading to Room A. The facility has met all the posting requirements. The indoor activity space measurement for the current requested capacity is as follows: Room # A is: 693.86 square feet divided by 35 square feet=19.82 (20 children). Crib area is 121.69 square feet which is not included in the activity measurement. There are 2 diaper changing tables in the classroom that has 4 raised sides at least 3 inches. The diaper changing tables are located within the arm's reach of a sink. The director stated there are additional staff in the infant room to supervise children while the other staff is changing diapers. LPA discussed the procedures and position of diaper changing with director. She said the staff disinfect Continued on page 2

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

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 3

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: OC KIDS CHILDCARE INC.	FACILITY NUMBER: 304370632
	VISIT DATE: 06/08/2023

NARRATIVE

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the diaper changing pad surface before and after each use and follow the diaper changing procedure. The school representatives were reminded to make sure the staff never leave a child unattended on the diaper changing table.

Total outdoor activity space measurement is as follows:
Outdoor space for the infant/toddler playground is: 1466.15 square feet divided by 75 = 19.55
(20 children). Shade is provided by building shade and a large umbrella.
Total of toilets: 2 X 15 = 30 children
Total of sinks: 2 X 15 = 30 children
The school representatives stated the smoke detector and carbon monoxide are combined in the device and they were installed in the ceiling. The infant classroom has age appropriate toys and equipment.
A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the applicant/facility representative. English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold.
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SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: OC KIDS CHILDCARE INC.	FACILITY NUMBER: 304370632
	VISIT DATE: 06/08/2023

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The representatives were reminded of safe sleep regulations and logging every 15 minutes check on infants and toddlers under 24 months old. A sample of the log was given. LPA also discussed the items not allowed in the childcare facilities for infants and toddlers. A flyer of the banned items was given to director.

Director's file was reviewed. The file is complete and she is current on CPR and 1st aide, and Mandated Reporter Training.

Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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

Orange county Fire authority has approved Room A for maximum of 20 infants and toddlers.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. A notice of site visit was given and must remain posted on, or immediately adjacent to the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the representatives.

Based on today’s indoor and outdoor measurements, the sinks and toilets availability, the request of the facility for moving to a new room (Room # A) for 20 children ages 6 weeks to 24 months old will be final reviewed and discussed with management in the Regional Office and after receiving the following. The facility will be notified if any additional information is required.

Please submit the following no later than 30 days of today's date.

1- Pictures of final arrangement of Room A after moving all the equipment and toys from the old room.

End of report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

LIC809 (FAS) - (06/04)

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