304370988-3-11-2020-06-CC-KDEI-BMLVUH-20200311164446

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370988
Report Date: 03/11/2020
Date Signed: 03/11/2020 04:44:54 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:	KIDDIE ACADEMY OF HUNTINGTON BEACH		FACILITY NUMBER:	304370988
ADMINISTRATOR:	CARREON, NICOLE		FACILITY TYPE:	840
ADDRESS:	19342 BEACH BLVD.		TELEPHONE:	(714) 968-0078
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY:	22	CENSUS: 5	DATE:	03/11/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Assitant Directo rAmber Prinzi (Lopez)		TIME COMPLETED:	05:00 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	Licensing Program Analyst (LPA), Ketki Desai conducted an unannounced Required 1 year inspection of the above facility on today's date. LPA Ketki Desai toured the facility with the Assistant Director Amber Prinzi (Lopez) This is a before and after school program. This facility has a separate preschool & Infant license.(304370986 and 304370987 ). The program is held in school age room # 7 There were five school age children present at the time of inspection with one staff meeting the staffing and child ratio. 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 6:30 am- 6.30 PM, Mon-Fri. Children are signed in upon arrival at 6.30 am and are transported by the staff to the school at 8.00 am and later are picked up upon school closure time. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. The school age program children have their own play yard and restrooms in the classroom. The facility was toured inside and outside and the floor and yard plan were verified. The facility representative stated there is no bodies of water on site. LPA confirmed with facility representative that firearms/weapons are not allowed or stored on premises. The facility appeared clean and orderly

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

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 HUNTINGTON BEACH	FACILITY NUMBER: 304370988
	VISIT DATE: 03/11/2020

NARRATIVE

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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.
Breakfast /PM Snacks & lunch are served by the facility, children are served lunch upon their return from school, along with snacks. There is drinking water available to children both indoors and outdoors. A current menu is posted in a prominent location viewable by an authorized representative. The facility representative stated menus are dated, kept on file for 30 days and viewable upon request. Food prep areas appear clean and sanitary. Food is properly stored. On site kitchen is free from hazards. Solid waste receptacles have a tight-fitting cover and are in good repair.
The activity items, floors, desks and other equipment appeared clean. The children's bathrooms are clean and sanitary. All materials and surfaces accessible to children are toxic free.

Children do not nap during their time in the facility . The program has conducted an emergency drill on January 28th 2020. 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. Children have been signed in and out with legal signatures.

During today's visit staffing ratios were being met. Children's and staff files were in compliance.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

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 HUNTINGTON BEACH	FACILITY NUMBER: 304370988
	VISIT DATE: 03/11/2020

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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.
Currently there are children receiving the above Medical services. Medication are stored in a locked cabinet in the Director's office.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org
Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

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).

During exit interview Report was reviewed and discussed. Appeal Rights was discussed and a copy was provided. The Administrator 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.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020

LIC809 (FAS) - (06/04)

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