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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371094
Report Date: 11/15/2019
Date Signed: 11/15/2019 04:17:28 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 LEARNING ACADEMYFACILITY NUMBER:
304371094
ADMINISTRATOR:WYATT, JENNAFACILITY TYPE:
830
ADDRESS:3516 W. COMMONWEALTH AVENUETELEPHONE:
(714) 680-0567
CITY:FULLERTONSTATE: CAZIP CODE:
92833
CAPACITY:8CENSUS: 5DATE:
11/15/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Kristy Lawrence, DirectorTIME COMPLETED:
04:30 PM
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An unannounced required inspection was conducted by the Licensing Program Analyst (LPA) Torrence on 11/15/2019. Upon arrival LPA met with Lead Teacher Jabeen Hameed. Director Kristy Lawrence arrived around 2:30 p.m. Director guided analyst on a tour of the facility indoors. There was one staff supervising five infants napping on cots. 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. This facility operations hours are 6:30 am to 6:00 pm., Monday-Friday, serving ages birth to 24 months in room #3.

The facility was reviewed to ensure compliance with license conditions and limitations, staffing and ratios, inaccessibility to poisons, medication, and hazardous items that can pose a danger to children. Equipment and furniture were inspected to ensure it's in good condition, free of sharp, loose or pointed parts. The bins had tight fitting covers. The napping area is separated from the activity area and has sufficient infant napping equipment. There were no baby walkers observed on the premises. The changing table is within the arm's reach of a sink. Bottles and dishes are labeled with the current date and children's names. The infants were being supervised in the napping area. Per Director, there are no weapons, firearms in the facility.

Staff's files were reviewed for education verification, CPR/First Aid, and new immunization requirements; such as, Measles, Pertussis, and Influenza vaccines. A sample of children's files were reviewed for completeness of medical assessment, and verification of sign in/out including time the child was signed in/out by authorized representative as well as verification of representative’s full legal signature. The facility has an individual feeding plan for each infant and each infant has an infant Needs and Services Plan. The facility have a current children’s roster and an updated fire/disaster drill.

SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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 LEARNING ACADEMY
FACILITY NUMBER: 304371094
VISIT DATE: 11/15/2019
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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. 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.htmThe updated plan of operation has been received in our office for providing Incidental Medical Services. (IMS).

The facility representative was informed that licensing updates, regulations, and forms are located on the CCLD website: www.ccld.ca.gov . Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov

There was no deficiency cited per CA Code of Regulations Title 22, Division 12.



Report was reviewed and discussed. The licensee was provided a copy of their appeal rights and their signature on this form acknowledges receipt of these rights. The Notice of Site Visit was posted. 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. This report is to be on file and accessible for public review at the facility for at least 3 years.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
LIC809 (FAS) - (06/04)
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