304371138-11-4-2019-06-CC-THOO-BHLQLU-20191104111631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371138
Report Date: 11/04/2019
Date Signed: 11/04/2019 11:16:40 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:	TAMURA CDC PRESCHOOL		FACILITY NUMBER:	304371138
ADMINISTRATOR:	MONA GREEN		FACILITY TYPE:	850
ADDRESS:	17340 SANTA SUZANNE ST		TELEPHONE:	(714) 962-4099
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	24	CENSUS: 22	DATE:	11/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Teacher Barbara Kraus		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 Annual/Random inspection was conducted on this date by Licensing Program Analyst (LPA) Ho. Upon arrival LPA met with teacher Barbara Kraus and toured the facility. LPA observed 22 preschool children with 2 staff members in room 30. The facility is operating within its licensed capacity and within compliance of staffing ratios. This program locates on Tamura Elementary, but is not a Title 5 funding. Operating hours are 7am- 6pm, Monday through Friday. The facility was toured inside and outside and the floor and yard plan were verified. No bodies of water observed on-site. LPA confirmed with facility representative that firearms/weapons are not allowed or stored on premises. The facility was clean and orderly. The items which could pose a danger to children (disinfectants and cleaning solutions) were stored out of the reach of children. No Poisons/Hazardous items in the classroom. All materials and surfaces accessible to children are toxic free. The children’s bathrooms were observed to be in safe and sanitary operating conditions. All floors are clean and safe. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Snacks are provided. Food prep areas appear clean and sanitary. Food is properly stored. Solid waste receptacles have a tight-fitting cover and are in good repair. Children nap on mats, and bedding is sent home weekly to be laundered by parents. There is drinking water available to children both indoors and outdoors. A current menu is posted is a prominent location viewable by an authorized representative. The facility has a working smoke detector, carbon monoxide detector, and fire extinguisher that meet statutory requirements. 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 has conducted an emergency drill within the past six months. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy Ho	TELEPHONE: (714) 296-6577
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019

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: TAMURA CDC PRESCHOOL	FACILITY NUMBER: 304371138
	VISIT DATE: 11/04/2019

NARRATIVE

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legal signature and records the time of the day. The child is signed in and out for the person responsible for the child. A random sample of five children's files were reviewed for an admission agreement and found to be in substantial compliance.

Staff files for staff present during today’s inspection were reviewed for appropriate documentation of education credits. There were enough staff member present possesses current CPR/First Aid certifications. Proof of immunization's against influenza (or written decline), pertussis and measles for all employees/volunteers were reviewed for compliance with SB 792. Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years, per A.B. 1207. Proof of completion as required by AB 1207 was observed in staff files.

Facility provides Incident Medical Services (IMS) and currently have some children with IMS.

After a tour of the center and review children and staff's records, no deficiency was observed.

Exit interview was conducted with director. Report reviewed and discussed. Notice of Site Visit was posted during the visit. 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. Appeal rights provided and explained. The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy Ho	TELEPHONE: (714) 296-6577
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019

LIC809 (FAS) - (06/04)

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