304370673-1-31-2025-06-CC-SGAA-DDFU3P-20250131141351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370673
Report Date: 01/31/2025
Date Signed: 01/31/2025 02:14:05 PM

Document Has Been Signed on 01/31/2025 02:14 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	PAGE SCHOOL OF COSTA MESA		FACILITY NUMBER:	304370673
ADMINISTRATOR/ DIRECTOR:	DICKSON, KRISTIN		FACILITY TYPE:	830
ADDRESS:	657 VICTORIA STREET		TELEPHONE:	(949) 515-1700
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 32	CENSUS: 24	DATE:	01/31/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:50 AM
MET WITH:	Assistant Director, Berenice Thorin		TIME VISIT/ INSPECTION COMPLETED:	12:45 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	On 1/31/2025 at 8:50am, Licensing Program Analyst (LPA), Sarah Garcia conducted an onsite inspection for the purpose of an Annual Random. LPA met with director, Kristin Dickson and assistant director, Berenice Thorin. LPA and assistant director, Berenice Thorin conducted a walk-through of the facility inside and outside and the floor and yard plan were verified. Census was taken in individual classrooms. The overall census observed was 24 infants and 9 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7a.m.- 5p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Parents provide breast milk, formula and baby food. Food is properly labeled and stored. The facility has sufficient infant napping equipment that meets the requirements. The facility has indoor activity space for infants that is physically separate from space used by preschool childcare center. LPA observed the changing table with a sink next to it. Drinking water in the indoor activity space is provided by bottles with the child’s name on it. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. The facility has conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector, smoke detector, and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility. Continued on Page 2

Martha Malane	TELEPHONE: (310) 740-3022
Sarah Garcia	TELEPHONE: (279) 200-2078
	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PAGE SCHOOL OF COSTA MESA	FACILITY NUMBER: 304370673
	VISIT DATE: 01/31/2025

NARRATIVE

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The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material, around the climbing equipment, slides and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by sports bottles with the child’s name on it. The outdoor equipment and toys were in good repair and free of sharp edges. LPA observed a body of water on the elementary/middle school grounds which is approximately 200 feet from the infant classrooms. LPA observed the access gate that opens away from the pool and is self closing with a key lockable device 38 inches above the ground. This lockable device does not meet regulation and LPA will issue a Type B citation. LPA took photographs. The facility grounds were safe, sanitary and in good repair.

Staff files were reviewed for staff present during the facility inspection on this date, 4 out of 9 staff files were reviewed. Health screening and immunizations as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1596.7995 states, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for staff were reviewed and within compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 06/2025.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of (4) of children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. LPA observed (1) infant from 0-12 months. LPA observed and reviewed LIC 9227 Individual Infant Sleeping Plan in children’s files. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day.

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SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (279) 200-2078
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PAGE SCHOOL OF COSTA MESA	FACILITY NUMBER: 304370673
	VISIT DATE: 01/31/2025

NARRATIVE

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Assistant Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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 water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four LPA referred Assistant Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

The Assistant Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov and may request to be added to an email list to receive a Quarterly Update. The Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The Assistant Director was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.
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SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (279) 200-2078
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PAGE SCHOOL OF COSTA MESA	FACILITY NUMBER: 304370673
	VISIT DATE: 01/31/2025

NARRATIVE

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LPA discussed the safe sleep regulations with Assistant Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed assistant director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

Assistant Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on LPAs observations the following violation(s) was observed is being cited in accordance with Health and Safety Sections 1596.814(a)(1)(A)(i) , is being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with the Assistant Director, Berenice Thorin. A notice of site visit was given and must remain posted for 30 days. Failure to post will result in Civil Penalties of $100.00.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process. End of Report

SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (279) 200-2078
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 01/31/2025 02:14 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PAGE SCHOOL OF COSTA MESA	FACILITY NUMBER: 304370673
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

HSC

1596.814(a)(1)(A)(i)

Pool Safety

(A) An enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family daycare home and has all of the following characteristics: (i) An access gate that opens away from the swimming pool and is self-closing with a self-latching, key lockable device placed no lower than 60 inches above the ground. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in LPA observed the access gate that opens away from the pool and is self closing with a key lockable device 38 inches above the ground which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Facility will submit waiver to Orange County Regional Office by 5pm on 2/14/2025. If the waiver is denied, the facility will install a new lockable device that is no lower than 60 inches above the ground.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Martha Malane	TELEPHONE: (310) 740-3022
Sarah Garcia	TELEPHONE: (279) 200-2078
	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

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