304371281-8-8-2019-06-CC-SHAS-BEUPEV-20190808111545

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371281
Report Date: 08/08/2019
Date Signed: 08/08/2019 11:16:04 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:	BESWICK CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	304371281
ADMINISTRATOR:	ARENAS-GARCIA, JACQUELINE		FACILITY TYPE:	840
ADDRESS:	1362 MITCHELL AVENUE		TELEPHONE:	(408) 556-7300
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	70	CENSUS: 0	DATE:	08/08/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kristen Raibon		TIME COMPLETED:	11:40 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	Licensing Program Analyst (LPA) Hawkins and LPA Port conducted an on site prelicensing visit at this proposed child care center. LPA met with Kristen Raibon and toured center. The applicant has requested to provide care and supervision for 70 children 4.9 to 12 years of age, Monday through Friday, 7:00 AM to 6:00 PM. Office area is located in the front corner of the Room 1 and will serve as the isolation area for ill children temporarily until parents arrive. Medication will be stored in a location inaccessible to children in care. First Aid kit is complete and located in the file cabinet. Sign in / Sign out record was reviewed and meets regulation requirements. Food preparation area is equipped with microwave oven, refrigerator/freezer. Center policy is that breakfast, lunch, and AM/PM snacks are provided by the center and will be prepared in the school lounge and delivered to the classrooms by staff. Evaluator reviewed Title 22 Sections 101227 and 101327 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food. Classrooms are adequately equipped with age and size appropriate furniture and equipment. Drinking water in the indoor/outdoor activity space will be supplied by a water cooler and children may also use school water fountains. The district can use the room as a classroom as arranged with the center. The licensing office received a district certified statement stating that classroom #1 and classroom #2 are of sufficient size to accommodate public instruction (for up to 35 children each). Fire clearance from the Orange County Fire Authority was received and supports the requested capacity of 70 children. Per Health and Safety Code 1596.806(1)(A), facility is exempt from Title 22 indoor/outdoor square footage and toilet requirements. The facility is located on school ground campus of Benjamin F. Beswick Elementary School and classrooms have been certified for public instruction. Continued on page 2

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019

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: BESWICK CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 304371281
	VISIT DATE: 08/08/2019

NARRATIVE

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The facility shall use the restrooms in the A Wing and restrooms near the playground area. The center shall have exclusive use of the restrooms during operation hours.

The outdoor playground will be shared with the elementary school on a rotating basis. Playground is completely enclosed by a fence. Outdoor activity area is supplied with age and size appropriate equipment including a climbing structure. An adequate amount of cushioning material is in placed under the structure. Shade will be provided by shade covers and outdoor umbrellas.

Prior to licensing the following areas / documents must be corrected / submitted:
1. Proof of installed shade covers and outdoor umbrellas (pictures via email)

This file will be subject to a final in office review prior to licensure.

Applicant was notified about teacher to 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. A hard copy of Form LIC 311A, Records to be Maintained at the Facility was provided to the facility representative. 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.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene Hawkins	TELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019

LIC809 (FAS) - (06/04)

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