304370932-9-4-2019-06-CC-KDEI-BFPQ9W-20190904115903

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370932
Report Date: 09/04/2019
Date Signed: 09/04/2019 11:59:20 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:	ALEPH PRESCHOOL		FACILITY NUMBER:	304370932
ADMINISTRATOR:	SIEKALY, RONA		FACILITY TYPE:	850
ADDRESS:	19045 YORBA LINDA BLVD.		TELEPHONE:	(714) 693-0770
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92886
CAPACITY:	30	CENSUS: 10	DATE:	09/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Administrator Siekaly Rona		TIME COMPLETED:	12:15 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), Ketki Desai conducted an unannounced annual/random inspection of the facility on today's date. LPA Ketki Desai toured the facility with the Administrator , (Seikaly Rona) inside and outside. The Preschool sessions are held in 2 designated classrooms ( Room #1 and 2). A review of staff criminal clearance records on this date 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 7.00 AM- 6.00 PM, Monday to Friday. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Children bring in their own lunch/ snacks / Milk or Juice from home, if needed the food is warmed up by the staff. Children also bring in their own water bottles, additional water is filled up as needed. During outdoor activities, water bottles are carried out. The children's bathrooms are clean and sanitary. Children do nap during their time in the facility and the sleeping cots/ mats are stored appropriately. Linens are washed on a weekly basis by the parent and additional linens were observed. Isolation area is in the Director's office and additional mat / linen is available.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

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: ALEPH PRESCHOOL	FACILITY NUMBER: 304370932
	VISIT DATE: 09/04/2019

NARRATIVE

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Facility also has conducted an emergency / fire drill within the past month. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. The playground was completely fenced. The playground equipment appeared in safe condition. There is enough cushioning underneath climbing structures and/or play equipment to absorb falls and has enough shade.

Sign in/out procedure was reviewed for compliance. At least one staff member present possesses current CPR/First Aid certification, which expires 08/2020. Children's and staff files were reviewed and are in compliance.

The facility does provide Incident Medical Services. Currently there are no enrolled children receiving the services.
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.

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov.

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

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: ALEPH PRESCHOOL	FACILITY NUMBER: 304370932
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/04/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/04/2019 Section Cited	1 2 3 4 5 6 7	Immunizations: Employees or volunteers at day care center;(a) (1) Commencing September 1, 2016, 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.
	8 9 10 11 12 13 14	Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.This evidence is not met by evidence of record review of the Volunteer at CCC, not having a proof of immunization. This poses a potential risk to H&S to children in care.	8 9 10 11 12 13 14
Type B 10/04/2019 Section Cited	1 2 3 4 5 6 7	Mandated Reporter training: Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion is needed.
	8 9 10 11 12 13 14	This requirement is not met by evidence of record review of the Volunteer at CCC not having the required Mandated reporter training. This poses a potential risk to H&S to children in care.	8 9 10 11 12 13 14

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) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

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: ALEPH PRESCHOOL	FACILITY NUMBER: 304370932
	VISIT DATE: 09/04/2019

NARRATIVE

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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.

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 Updates are available at www.ccld.ca.gov

Exit interview was conducted. Report reviewed and discussed.
Notice of Site Visit was posted during the visit. The director was provided a copy of their appeal rights (LIC 9058 01/16) Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

The director was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.

Following documents received on today's date of inspection from the facility Director
LIC 500/ LIC 610 and LIC 308.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

LIC809 (FAS) - (06/04)

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