304370880-6-27-2019-06-CC-DVAA-BDHPLT-20190626112515

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370880
Report Date: 06/26/2019
Date Signed: 06/27/2019 08:20:23 AM

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:	KIDDIE ACADEMY OF TUSTIN		FACILITY NUMBER:	304370880
ADMINISTRATOR:	PINELA, NATASHA		FACILITY TYPE:	830
ADDRESS:	14501 NEWPORT AVENUE		TELEPHONE:	(714) 508-0005
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	36	CENSUS: 22	DATE:	06/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:16 AM
MET WITH:	Elaina Alcaraz, Director		TIME COMPLETED:	11:45 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	An inspection was conducted at the facility by LPA Dean Valencia. The facility file was reviewed prior to this inspection being conducted. A review of the personnel records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Operating hours are 6:30am to 6:30pm, Mon-Fri. The facility has toddler option for up to 24 toddlers (18mo-36mo), in room #2. The facility was toured inside and outside and the floor and yard plan were verified. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. This is a combination center with a separate preschool license. Indoor and outdoor activity space for infants is separate from other age groups. There were 6 staff and 22 infants/toddlers present during the inspection. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were inaccessible to children. Poisons/hazardous items are not stored on site and none were observed. The toys, floors and other equipment appeared clean, safe and age appropriate for infants. There is sufficient napping equipment for the infants, and cribs and bedding are within compliance. Bedding is laundered on site daily. The changing table is within arm’s reach of a sink, and appears clean and sanitary. All food provided for infants are brought by parents, and are named and dated daily. Bottles and food containers brought from home are properly labeled with name and date and stored in an refrigerator in the classroom. Garbage cans containing solid waste have tight fitting lids. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the facility. The playground is completely fenced and free of hazards. The playground equipment appeared in safe condition. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Children and staff records were reviewed and within compliance. The sign in/out procedure was reviewed and in compliance. At least one staff member present possessed current CPR/First Aid certifications, which expire 2/2020. Incidental Medical Services (IMS) policy was discussed. (continued on LIC809C)

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: KIDDIE ACADEMY OF TUSTIN	FACILITY NUMBER: 304370880
	VISIT DATE: 06/26/2019

NARRATIVE

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For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. Infant needs and services plans were reviewed, and discussed with the director. The plans need to be updated and reviewed with parents on a more regular basis.
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
Proof of immunization's against pertussis, influenza (or written declination), and measles for all employees/volunteers are on file and within compliance. All licensing reports are public information and must be made available upon request. This report was reviewed and discussed with the the care provider. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. The training certificates were reviewed and discussed with the director
A pamphlet of Effects of Lead Exposure was provided for care provider and discussed.

Exit interview was conducted, and report, deficiencies, and advisory notes was reviewed and discussed. Notice of Site Visit was posted during the visit. 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 licensee was provided a copy of their 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. and accessibility and access to the website was discussed with the care provider. This report is to be on file and accessible for public review at the facility for at least 3 years.

he following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see attached LIC 809D.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: KIDDIE ACADEMY OF TUSTIN	FACILITY NUMBER: 304370880
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/26/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101419(a)

Children Records - Infant Needs and Services Plan

(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on a record review of the infant/toddler files, the licensee did not comply with the section cited above documenting all required aspects of the infant needs and service plans, nor were they being updated at least quarterly and signed by the parent(s). This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	The director stated she will revamp the facility's infant needs and services plans to include all required areas peer the regualtions, and begin having the infant teachers address these plans with parents. Teachers will have the parent sign the new plans, and continue to update these plans with the parents at least quarterly. Director stated she will submit proof of this to LPA, by 7/17/19, and LPA contact information was left with the facility.

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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean Valencia	TELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

LIC809 (FAS) - (06/04)

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