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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371048
Report Date: 11/07/2019
Date Signed: 11/07/2019 03:16:37 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:CASA ALEGRIAFACILITY NUMBER:
304371048
ADMINISTRATOR:THOMAS, JOYFACILITY TYPE:
840
ADDRESS:1060 PAULARINO AVE ROOMS A & BTELEPHONE:
(714) 650-9452
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY:35CENSUS: 2DATE:
11/07/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Amanda TiradoTIME COMPLETED:
03:45 PM
NARRATIVE
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This is an annual continuation due to computer malfunction on 11/6/19. An inspection was conducted at the facility by Licensing Program Analyst (LPA) Hawkins. The facility file was reviewed prior to this inspection being conducted. LPA Hawkins met with Director Joy Thomas and Amanda Tirado and conducted a facility inspection. Upon arrival there was 2 staff and 2 children present. During the inspection the director and one child left the facility for a scheduled outing. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance.
Operating hours are 8am-6pm, Mon-Fri, open year round. The facility is located on the campus of Paularino Elementary School, in rooms A and B. The facility was toured inside and outside and the floor and yard plan were verified. During the inspection it was determined that 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 locked in a janitorial area. Food is prepared on site; snacks are provided. Food prep areas appear clean and sanitary. Food is properly stored. The toys, floors, desks and other equipment appeared clean. There is drinking water available to children both indoors and outdoors. The children's bathrooms are clean and sanitary. Children do not nap on site. The facility does not have record of conducting an emergency drill within the past six months. Director stated that a fire drill was conducted in October, however was not documented. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher. LPA observed two missing ceiling panels in Room A and director stated that the panels were damaged by the rain and was removed. The playground was completely fenced. The playground equipment appeared in safe condition, and play area is free from hazards. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. The facility uses the school's outdoor play area. Sign in/out procedure was reviewed for compliance. At least one staff member present possesses current CPR/First Aid certifications, which expires 06/2021. Children's and staff files were reviewed for compliance. Children's files were reviewed for Emergency Information form (LIC 610) and was found to be complete. Staff files were reviewed for educational requirements and were found to be complete.
(continued on LIC809C)
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: CASA ALEGRIA
FACILITY NUMBER: 304371048
VISIT DATE: 11/07/2019
NARRATIVE
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page 2
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

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.

Based on LPA's observations the following violations were observed are being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101238(a) Buildings and Ground, Section 101174(d)(2) Disaster and Mass Casualty Plan and are being cited on the attached LIC 809D.

The facility representative was 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 The facility representative may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov

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 A copy of the Nutritious Beverage Bill was provided to the facility representative.

continued on page 3
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CASA ALEGRIA
FACILITY NUMBER: 304371048
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2019
Section Cited

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101238 (a) Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by: There were two ceiling panels in Room A that were missing. Director stated that the panels were damaged by the rain
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which was the reason they were removed. This poses a potential Heath and Safety risk to the children in care.
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Type B
11/22/2019
Section Cited

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101174(d)(2) Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement was not met as evidenced by:
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Based on record review and interview with director, director failed to document fire/ disaster drill log after each drill. Director stated that a fire drill was conducted in October, however was not documented. This poses a potential Health and Safety risk to the children in care.
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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 HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CASA ALEGRIA
FACILITY NUMBER: 304371048
VISIT DATE: 11/07/2019
NARRATIVE
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An exit interview was completed. The report was reviewed and discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and LIC 809D and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.

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 $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4