304370702-1-15-2020-06-CC-LBAS-BKUUWY-20200115145730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370702
Report Date: 01/15/2020
Date Signed: 01/15/2020 02:57:46 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:	SUNFLOWER PRESCHOOL & KINDERGARTEN		FACILITY NUMBER:	304370702
ADMINISTRATOR:	GARDUNO, MICHELLE		FACILITY TYPE:	850
ADDRESS:	2129 W EDINGER		TELEPHONE:	(714) 979-7422
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92704
CAPACITY:	59	CENSUS: 47	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Director Jazmin Ortiz		TIME COMPLETED:	03:20 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’S), Barajas and Odom conducted an on site inspection for the purpose of an Annual Random. LPA’s and Director Jazmin Ortiz toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 5 preschool staff and 47 preschool children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. 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 in kitchen Cabinets. Poisons/Hazardous Items are not kept on the premises. Food is prepared on site; breakfast, lunch and snacks are provided. Food prep areas were clean and sanitary. Food is properly stored. Menus were posted where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by drinking fountain and cups and pitcher. The children's bathrooms are clean and sanitary. Children nap on cots/mats, and bedding is stored individually and is taken home weekly to be washed by parents at end of week. The facility has conducted an emergency drill within the past six months, last conducted on 12/26/19. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirements. The California Child Passenger Safety Law was posted by the entrance of the facility Staff files were reviewed for staff present during the facility inspection this date. 7 out of 8 staff files were reviewed. Health screening and immunization's as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a day care facility if he or she has not been immunized against influenza, pertussis, and measles. Page 1, Continued on Page 2

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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 5

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: SUNFLOWER PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304370702
	VISIT DATE: 01/15/2020

NARRATIVE

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Proof of immunization against pertussis, measles for Director and 7 Staff were reviewed and within compliance. All Staff provided Influenza/Flu declination letter. 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. All employees have Mandated Reporter Training on file. At least one staff member present poses current EMSA approved Pediatric CPR/First Aid certifications, which expires 09/20/2021. According to Kit 1, LPA’s reviewed Staff files and verified all Staff have Health Screening Report (LIC 503).

The Director was informed that the Criminal Record Statement (LIC 508) has been updated, and the facility must now use the new form with revised date 7/15. Director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 10 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: Physicians Report LIC 701). In the areas reviewed the children’s files were found to bnot be in full compliance. Children's files were missing (LIC 9224) for Licensing Report dated 11/18/19. 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.

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

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at
least four feet in height.
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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: SUNFLOWER PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304370702
	VISIT DATE: 01/15/2020

NARRATIVE

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The surface of the outdoor activity space was well maintained and free of hazards. The
cushioning material turf, and playground rubber surface commercially produced for the purpose
around the climbing equipment, swings, slides and other similar equipment appeared to be enough to absorbs
falls. Drinking water in the outdoor activity space is provided by drinking fountain and cups and pitcher. The outdoor equipment and toys were in good repair and free of sharp edges. There is no body of water present at the facility. The facility grounds were safe, sanitary and in good repair.Licensee was reminded to have 100% visual supervision at all times, specifically outdoors.

Transfer Request (LIC9182). The Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov Director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
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 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.

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: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: SUNFLOWER PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304370702
	VISIT DATE: 01/15/2020

NARRATIVE

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Documents/Information to be updated and returned to the Licensing Office;
-Facility Sketch (LIC 999)

In the areas that were evaluated, deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit, are cited on attached LIC 809D.

Based on LPA’s record reviews on today's date and interview with Director Jazmin Ortiz the following violation was observed: 9 out of 10 children file records reviewed did not have Acknowledgement of Receipt of Licensing Reports (LIC 9224), for Licensing Report issued on 11/18/2019. Director Jazmin Ortiz disclosed parents were not provided licensing form (LIC 9224) or copy of Licensing Report dated 11/18/2019 for Care and Supervision CCR 101229(a)(1) and therefore being cited in accordance with California Code of Regulations, Title 22, Division 12, Health and Safety 1596.8595(c ), is being cited on the attached LIC 809D.

A Case Management was also conducted for the purpose of a Decision and Order received by the Department and effective as of 01/03/2020, to verify employee Angelica Morales is no longer working at the facility. Per Director Jazmin Ortiz, Angelica Morales is no longer employed as of November 2018.

An exit interview was completed with Director Jazmin Ortiz. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

End of Report

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: SUNFLOWER PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304370702
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/15/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/22/2020 Section Cited	1 2 3 4 5 6 7	Health and Safety Code Section 1596.8595 (c)...reports to be provided to parents or guardian of each child receiving services (c ) A licensed child care facility or home shall provide to the parents of each child receiving services in the facility copies of any licensing report that documents any Type A citation ... This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on 9 of 10 children records reviewed all were missing LIC 9224 dated 11/18/2019 and interview with Director Jazmin Ortiz who disclosed the Licensing Report dated 11/18/19 Type A for Care and Supervision CCR 101229(a)(1) was not provided to Parents. This is a potential safety risk to the children in care.	8 9 10 11 12 13 14
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor Barajas	TELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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