304371149-8-20-2019-06-CC-YVIA-BF8MS4-20190820095119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371149
Report Date: 08/20/2019
Date Signed: 08/20/2019 09:51:23 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:	GRACE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	304371149
ADMINISTRATOR:	PORTENEUVE, SHELBY		FACILITY TYPE:	850
ADDRESS:	4545 MYRA AVENUE		TELEPHONE:	(714) 761-5200
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY:	36	CENSUS: 0	DATE:	08/20/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Shelby Porteneuve, Director		TIME COMPLETED:	10:30 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 announced Pre-Licensing visit was conducted today by LPA Yesenia Villa. LPA met with Director Shelby Porteneuve. This is a licensed preschool facility with a current capacity of 36 children. The applicant has applied for an increase in capacity to 60 children serving ages 2-5yrs of age. This facility is located at Grace Christian School Campus and will operate from 6:30am to-6pm, Monday through Friday. Facility will be open year-round. The program offers part day and full day programs.. Rooms #26 and #27 and#10 will be used for child care. Applicant is seeking to provide care for 60 preschool children. LPA toured the entire facility indoors & outdoors and the following measurements were taken: Indoor: Room #26: 30 x 23 6' = 705 minus 8 x 7 = 56 Room #27: 30 x 23 6'= 705 minus 8 x 7 = 56 = 37 children. Room#10: 30 x 29 =870 = 24 children- Increase in capacity bringing total capacity to (60) children. Toilets and sinks: (There are 2 toilets and 2 sinks available to children inside classrooms #26 and #27. When children are playing in the shared outdoor play area, they will use a shared restroom with the elementary school. Shared elementary school restroom has multiple toilet/urinals and sinks available for children.) Toilets 8 x 15 = 120 children Sinks 6 x 15 = 90 children Outdoor: 158 ft. X 48 ft. = 7,584/75 = 101 children (The outdoor play area will be shared with the Elementary School Kindergarten and T-K class. A waiver was approved on 02/10/17 for shared playground and the use of elementary restroom.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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: GRACE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304371149
	VISIT DATE: 08/20/2019

NARRATIVE

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Fire clearance from Orange County Fire Authority has been received and approved for requested capacity.
Base on today’s measurement and the sink & toilet availability, center has enough activity space to support the requested capacity of 60 children.
The following was observed:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking fountains and water bottles are available for inside and outside drink.
· Playground is fully enclosed by an appropriate fence.
· Outdoor activity area is supplied with age and size appropriate equipment.
· Adequate shade is provided by canopies.
· Lunch and snacks are provided by the facility, or children can bring meals from home
· The nurses office will serve as the isolation area for ill children until parents arrive.
· A separate staff restroom is available for adults.
· Medication will be stored in each classroom and will be inaccessible to children.
· First Aid kit is complete.
· Sign in/Sign out will be done on a checklist by the front door of the facility, and meets regulation requirements. Facility representatives understand full legal signatures are required when signing in/out.
- An area for all required postings, which were discussed.
Applicant was notified about emergency/disaster drills, posting requirements, children records, mandated child abuse and injury/ death reporting, and fingerprint clearance requirements. Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if A violations are cited then the Licensing Report (LIC809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed.
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.htmHard copy and link of Child Care Providers Guide to Safe Sleep provided to licensee on this day: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf Facility meets all licensing requirements and file will be submitted for approval as of today. Exit interview was conducted and a copy of this report was provided to Director, Shelby Porteneuve. A copy of this report must be made available to the public for 3 years.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

LIC809 (FAS) - (06/04)

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