304370764-11-22-2019-06-CC-GCOY-BJ6ULC-20191122144030

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370764
Report Date: 11/22/2019
Date Signed: 11/22/2019 02:40:44 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:	KRISTIN'S KIDDIELAND		FACILITY NUMBER:	304370764
ADMINISTRATOR:	SIMMONS, KRISTIN		FACILITY TYPE:	850
ADDRESS:	27101 ALISO CREEK RD #150,152,		TELEPHONE:	(949) 903-5437
CITY:	ALISO VIEJO	STATE: CA	ZIP CODE:	92656
CAPACITY:	30	CENSUS: 19	DATE:	11/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Natasha Luke		TIME COMPLETED:	03:00 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	An annual inspection was conducted at this facility by Licensing Program Analyst (LPA) Connolly. The facility file was reviewed prior to this inspection being conducted. LPA met with assistant director Natasha Luke. Facility was toured. Census was taken. There were 19 preschool children in care with two attending staff. All children at the time of the LPA's arrival were awake and actively engaged in the activities of the center. No toddler option children were present. Staff related no toddler option children are currently enrolled. Facility is operating within its licensed preschool capacity and within compliance of staffing ratio. A review of criminal clearance records on this date indicates adults who require caregiver background checks have received criminal record and child abuse index clearances. LPA confirmed operating hours continue to be Monday through Friday 7:30 AM -- 5:30 PM. The facility appeared clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Staff denied poisons/hazardous Items are stored on the premises and none were observed. Lunch and snacks are prepared on site. Menus are posted. All food capable of rapid spoiling are stored in the working refrigerator. The food prep area was observed clean, free of litter. There is drinking water available to children both indoors and outdoors. Children bathrooms were observed in safe and sanitary operating conditions. LPA observed children napping on individual mats. Individual bedding was observed stored in each child's labeled cubby. Continued on page two

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

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: KRISTIN'S KIDDIELAND	FACILITY NUMBER: 304370764
	VISIT DATE: 11/22/2019

NARRATIVE

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The playground is completely fenced. The playground equipment appeared in safe condition, and play area appears free from hazards. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. There are no bodies of water.

Children and staff files were reviewed. Staff present today provided copy of required health cards with expiration date 2/11/2021. The sign in and sign out forms were reviewed for full legal signatures
and recording time of day.

Incidental Medical Services (IMS) policy was discussed. Staff related there are no incidental medical services being provided at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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

The LPA provided a pamphlet on Lead Exposure. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf

There were no Title 22 deficiencies cited during today's inspection.

Exit interview was conducted. The licensing report was reviewed and discussed. Notice of Site Visit was posted during the inspection. The 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 per day. The assistant director was provided a copy of appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional manager, address is above on the report. The facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. This report is to be on file and accessible for public review at the facility for at least 3 years.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

LIC809 (FAS) - (06/04)

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