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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371198
Report Date: 12/15/2021
Date Signed: 12/15/2021 01:05:35 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:FIRST UNITED METHODIST CHURCHFACILITY NUMBER:
304371198
ADMINISTRATOR:CHERI PAYNEFACILITY TYPE:
850
ADDRESS:161 SOUTH ORANGETELEPHONE:
(714) 316-5933
CITY:ORANGESTATE: CAZIP CODE:
92866
CAPACITY:60CENSUS: 27DATE:
12/15/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator Ms. Payne, Cheri TIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Desai, Ketki conducted an unannounced Case Management Licensee initiated inspection at the above facility for the purpose of changing classrooms.

Currently facility is licensed for 48 preschool age children, 37 months to 6 years old in four designated rooms (Chapman Junction / Explorer Express/ Conductor Corner and Adventure Depot) along with Toddler option : 12 Toddlers (18 months to 36 months in one assigned room: Glassell Station.

Facility is now requesting to move the current Toddler option room from Glassell station into Chapman Junction and Glassell station the Toddler option room into a Preschool room .

No changes to the Outdoor activity yard and the total capacity remains at (60) 48: Preschool and 12 Toddlers

Facility Director Ms. Payne, Cheri gave a tour of the facility including new Toddler option classroom, Preschool rooms and outdoor space.

Per the new Application received facility is also requesting to change the ages of the preschool children being served to 2-6 years old while Toddler option age remains at (18 -36 months).

Operating hours for this program will be Monday to Friday 7:00 AM to 6:00 PM. Facility does offer a (full day session) and Half day session from 7:00 AM to 12:30 PM.


SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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 5
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 12/15/2021
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The following was observed in new Toddler Option room (Chapman Junction)
· Age appropriate furniture and equipment’s
· Educations items (Learning and tactile activity items) /Arts and Crafts activities.
· Room is well lighted with ventilation.
· Drinking water is available through filtered water pitchers and personal water bottles
· AM/PM snack is offered, and Lunch is brought from home, and these containers are labelled by the parents and stored in their individual cubbies.
· Electronic sign in and out (Bright wheel application)
· CDC Guidelines are being followed.
· Toddler classroom has a changing table with a sink within the arm’s reach
· Children in this room are in Diapers and classroom has three Potty Chairs and sink
· There is a specific preschool room (Glassell station) where children receive Potty training
· Children shall nap on cot and lines are brought from home.
· Facility has additional linens if needed.

On today’s inspection facility is adding new Toddler Option room (Chapman Junction) was measured as follows

Room Identification LengthWidth
Area
Encumbered
Space
Chapman Junction
22.67
21.67
491.26
491.26
12.83
10.75
137.92
22.03
115.89

Total indoor space: 607’15 divided by 35 = 17’35 (17 children)

Facility has requested to add 12 Toddlers in the new room Chapman Junction.

Total sinks: 1 X 15 = 15 children
Total Potty chairs: 3 X 15= 45(Children)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 12/15/2021
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Outdoor space: The facility has designated a Toddler yard, which was observed to be completely fenced, with grass and concrete flooring. There are several age appropriate climbing structures and additional outdoor toys. There is a walkway from the classroom leading to the toddler yard. There is a metal fencing in-between separating the preschool and Infant yard. The classroom has a direct access to the yard.

Outdoor Measurements :
Toddler Option Yard; 52'83 X 38'50 = 2033.96 divided by 75 = 27'12 (27 Toddlers)

Facility has sufficient yard space for 12 Toddlers.

Preschool:

Facility is now adding the Glassell station to the Preschool License along with the other three classrooms.

All the 4 Preschool classrooms (Glassell station / Explorer Express/ Conductor Corner and Adventure Depot were remeasured on today’s inspection and the measurements are as follows

Room Identification LengthWidth
Area
Encumbered
Space
Preschool: Glassell station
31.33
20.58
644.77
644.77
Preschool: Explorer express
10.83
9.42
102.01
16.99
85.02
27
21.92
591.84
591.84
Preschool: Conductor corner
30.92
19
587.48
41.88
545.60
Preschool: Adventure Depot
10.58
8.75
92.57
4.38
88.19
20.83
14.58
303.70
303.70

Total Indoor space (Preschool): 2259’12 divided by 35 = 64’55 (65 children)

Facility is having enough space to accommodate 48 Preschool age children in the four assigned rooms
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 12/15/2021
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LPA observed the following in each classroom
Classrooms are adequately equipped with age and size appropriate furniture and equipment.
·Drinking water is available by filtered water pitcher with cups and personal water bottles.
Classroom: Adventure Depot/ Explore Express and Conductor Corner has Toilets and sink inside the classroom, while there is one bathroom with Toilet, 1 Potty chair and sink outside Glassell station classroom for younger preschool age children where toilet training shall be done.
Each room has a sink and enough storage space for children and teaching staff.
Preschool age children nap on cots and linens are brought from home.

Total Sinks and Toilets
Sinks: 5 X15= 75 and 4 X 15= 60

Outdoor Preschool yard: The preschool yard is accessible from each classroom; the yard has a surrounding fencing with age appropriate play structures and climbing structures placed over the sand serving as a cushion. There is enough shade provided by a tree and covered patio area.

Preschool Yard: 69 X 52'83= 3645'27 divided by 75 = 48'60 (49 Preschool age children)

Fire clearance from Orange Fire Prevention Bureau has been received and approved for requested capacity.

After a tour of the center, no deficiency was observed.

Facility Administrator is current on the required Pediatric CPR/First Training: Valid up to 6/24/23

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).
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: FIRST UNITED METHODIST CHURCH
FACILITY NUMBER: 304371198
VISIT DATE: 12/15/2021
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The facility representative was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian Facility has access to the Guardian system.

Based on today’s Indoor and Outdoor measurements, sink & toilet availability, center has sufficient activity space to support the requested capacity of 12 toddlers in the assigned Chapman Junction (Toddler Option Room) along with the 48 Preschool age children (2 years to 6 years old) in the assigned 4 Preschool rooms : (Adventure Depot/ Conductor Corner/ Explorer Express and Glassell station) Operating hours: Monday to Friday 7:00 am to 6.00 PM.



Exit interview conducted.

Appeal rights presented to the Director. Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post it will result in civil penalties of $100.

SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5