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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371216
Report Date: 10/28/2019
Date Signed: 10/28/2019 02:57:41 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:LEPORT-IRVINE SPECTRUM -SOUTH CAMPUSFACILITY NUMBER:
304371216
ADMINISTRATOR:KWONG, AMYFACILITY TYPE:
830
ADDRESS:1 TECHNOLOGY DRIVE BLDG HTELEPHONE:
(408) 973-7337
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:36CENSUS: 27DATE:
10/28/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Amy Kwong, DirectorTIME COMPLETED:
03:15 PM
NARRATIVE
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An inspection was conducted at the facility by LPA Dean Valencia. The facility file was reviewed prior to this inspection being conducted. A review of the personnel records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Operating hours are 7am to 6pm, Mon-Fri. The facility was toured inside and outside and the floor and yard plan were verified. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. This is a combination center with a separate preschool license. Indoor and outdoor activity space for infants is separate from other age groups. There were 12 staff and 27 infants present during the inspection. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were inaccessible to children. Poisons/hazardous items are not stored on site and none were observed. The toys, floors and other equipment appeared clean, safe and age appropriate for infants. There is sufficient napping equipment for the infants, and bedding is within compliance. Bedding is laundered daily, on site. The changing table is within arm’s reach of a sink, and appears clean and sanitary. All food provided for infants are brought by parents, and are named and dated daily. Bottles and food containers brought from home are labeled with name and date and stored in a refrigerator in the classroom, although it was observed that several food/bottles were not properly labeled. Garbage cans containing solid waste have tight fitting lids. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the facility. The playground is completely fenced and free of hazards. The playground equipment appeared in safe condition. There is sufficient cushioning underneath climbing structures and/or play equipment to absorb falls. Children and staff records were reviewed and within compliance. The sign in/out procedure was reviewed and in compliance. At least one staff member present possessed current CPR/First Aid certifications, which expire 8/2021. 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. (continued on LIC809C)
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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 3
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: LEPORT-IRVINE SPECTRUM -SOUTH CAMPUS
FACILITY NUMBER: 304371216
VISIT DATE: 10/28/2019
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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
Proof of immunization's against pertussis, influenza (or written declination), and measles for all employees/volunteers are on file and within compliance. Infant needs and services plans are within compliance and updated at least quarterly. All licensing reports are public information and must be made available upon request. This report was reviewed and discussed with the the care provider. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
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. The training certificates were reviewed and discussed with the director
A pamphlet of Effects of Lead Exposure was provided for care provider and discussed.

Exit interview was conducted, and report, deficiencies, and advisory notes was reviewed and discussed. Notice of Site Visit was posted during the visit. 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 per day. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional manager, address is above on the report. The facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. and accessibility and access to the website was discussed with the care provider. This report is to be on file and accessible for public review at the facility for at least 3 years.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see attached LIC 809D.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LEPORT-IRVINE SPECTRUM -SOUTH CAMPUS
FACILITY NUMBER: 304371216
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/12/2019
Section Cited

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Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.

During a physical plant inspection of room #1 and room #3, it was observed that an infant
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was left in the nap room without a staff within proximity providing visual supervision. It was observed that while LPA was present doing the inspection, a staff member returned to the nap room and provided supervision. This has been determined by LPA to be a potential threat to the infants health and safety.
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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: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2019
LIC809 (FAS) - (06/04)
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