304371250-9-16-2019-06-CC-WPOT-BFVS8M-20190910133921

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371250
Report Date: 09/10/2019
Date Signed: 09/16/2019 11:10:33 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:	CANYON HILLS CHILDCARE/CANYON HILLS FRIENDS CHURCH		FACILITY NUMBER:	304371250
ADMINISTRATOR:	RICE, SHARLENE		FACILITY TYPE:	850
ADDRESS:	20400 FAIRMONT CONNECTOR		TELEPHONE:	(714) 695-0100
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92866
CAPACITY:	36	CENSUS: 7	DATE:	09/10/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:01 PM
MET WITH:	Sharlene Rice, Director		TIME COMPLETED:	02:05 PM

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	This is an amended report Licensing Program Analyst (LPA) Port conducted an inspection at the facility for the purpose of a capacity change. The applicant has requested to increase the overall capacity to 40 children from 36 by changing the toddler option program to the preschool license. The applicant has requested to provide care and supervision for from 28 preschool children 2 years of age to 5 years of age and 12 toddlers 18 months of age to 36 months of age Monday through Friday 7:00 AM to 6:00 PM. Rooms 101 and 104 will be used for preschool children. Room 102 will be used for toddler children. This facility has a separate infant license and is located on the grounds of Canyon Hills Friends Church. Approval from the Orange County Fire Authority has been received and supports the requested capacity of 40 children (12 toddlers and 28 preschool children) in Rooms 101, 102, and 104. During today's inspection LPA was guided on a tour of the facility. LPA observed 6 preschool age children and 1 staff member in Room 104 and 1 preschool child and 1 staff member in the outdoor play area. During today's inspection it was determined that the facility was operating within its licensed capacity and within compliance of staffing ratios. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance. There are a total of 5 toilets and 5 sinks have been designated for the infant/toddler and preschool program. (Total capacity of preschool and infants are 59 children which the number of toilets and sinks cover the total requested capacity for both programs. Measurements for this facility were obtained and are as follows: Indoor Activity Space: Room 101: 563 square feet Room 102 (Toddler): 411 square feet Room 104: 920 square feet Total indoor activity space: 1894 square feet/35 children = 54 children Page 1 of 3 (Continued on Page 2)

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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: CANYON HILLS CHILDCARE/CANYON HILLS FRIENDS CHURCH	FACILITY NUMBER: 304371250
	VISIT DATE: 09/10/2019

NARRATIVE

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This facility provides Incidental Medical Services -IMS. LPA reviewed storage of medication, equipment/supplies, and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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.htm

This facility meets the requirements for issuance of a capacity change effective on this date 09/10/2019. An updated license will be issued for the care and supervision of 28 preschool children 2 to 5 years of age and 12 toddlers 18 months to 36 months of age Monday through Friday 7 AM to 6:00 PM in Rooms 101, 102 (Toddler) and 104.

Exit interview was conducted with Director, Sharlene Lewis . 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. Facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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: CANYON HILLS CHILDCARE/CANYON HILLS FRIENDS CHURCH	FACILITY NUMBER: 304371250
	VISIT DATE: 09/10/2019

NARRATIVE

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Outdoor Activity Space (previously measured on 04/10/2019):
10,000 square feet divided by 75 is approximately 133 children.

A shared playground waiver for toddlers and preschool children to co-share the outdoor area on a rotating basis has been submitted to the licensing office. The outdoor play structure area has been prepped and the play structured is projected to be installed within 6 weeks.
The following was observed:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is 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 awnings
· Snacks and lunch is brought by each child
· The office will serve as the isolation area for ill children until parents arrive.
· A separate staff restroom is available
· Medication will be stored in each classroom in a locked cabinet
· Sign in/Sign out procedure was reviewed and meets regulation requirements
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements.

Director was reminded about teacher-child ratio requirements, direct visual supervision requirements, emergency/disaster drills, posting requirements, children records, mandated child abuse and injury/ death reporting, mandated reporter training, immunization requirements against measles, pertussis, and influenza and fingerprint clearance requirements.

Facility representative was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. A hard copy of the Department of Social Services Lead Information Brochure were explained and provided to the director.
(Continued on Page 3)

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Wendy Port	TELEPHONE: (714) 293-9315
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

LIC809 (FAS) - (06/04)

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