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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370779
Report Date: 08/12/2022
Date Signed: 08/12/2022 02:30:43 PM


Document Has Been Signed on 08/12/2022 02:30 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:SUNFLOWER PRESCHOOL & AFTER SCHOOL CENTER, INC.FACILITY NUMBER:
304370779
ADMINISTRATOR:KATHY LAFACILITY TYPE:
850
ADDRESS:10531 WESTMINSTER AVENUETELEPHONE:
(714) 534-5743
CITY:GARDEN GROVESTATE: CAZIP CODE:
92843
CAPACITY:119CENSUS: 0DATE:
08/12/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kathy La, Director TIME COMPLETED:
02:45 PM
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A case management inspection was conducted on this date by LPA Nguyen. The purpose for today's inspection was to ensure facility is in compliance with regulations. Upon arrival LPA met with director and toured the facility. LPA observed 0 children; 10 staff members including the director are present at the facility. LPA inspected the following areas: availability of drinking water, age appropriate sinks and toilets, water temperature, toilet paper, paper towels, medication policy, storage areas for poisons and furniture & equipment, food preparation areas, cleaning and food supply storage areas, outdoor equipment (safety, cushioning material, good repair, and age appropriateness, required shade, drinking water and fencing), play area (hazards and inaccessibility to bodies of water), teacher child ratios (staff names recorded), care and supervision, sign in and out sheets. A review of children’s & Staff records were reviewed to identify that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also observed Health Screenings and verification of CPR/First Aid (Exp: 10/2023). Staff’s required immunization (MMR, TDAP, FLU) were available for review.

Facility provides Incident Medical Services but currently does not have any children who require them.

Hard copy and link of Child Care Providers Guide to Safe Sleep provided to licensee on this day: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Web address for downloading forms or regulations was provided.

Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.

After a tour of the facility and review children and staff's records, no deficiency was observed.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina NguyenTELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:
DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2022
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: SUNFLOWER PRESCHOOL & AFTER SCHOOL CENTER, INC.
FACILITY NUMBER: 304370779
VISIT DATE: 08/12/2022
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During exit interview, “The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.” Notice of Site Visit was posted. Licensee was informed to keep the Notice of Site Visit posted for 30 days during the day care hours or $100 civil penalty will be assessed.
The facility representative 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. The facility representative was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Transfer Request (LIC9182). The facility representative was informed that Licensing Quarterly Updates are available 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 facility representative 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 and a copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina NguyenTELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022
LIC809 (FAS) - (06/04)
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