304371282-9-24-2019-06-CC-ATAR-BGBPEL-20190924111520

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371282
Report Date: 09/24/2019
Date Signed: 09/24/2019 11:15:55 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:	SHINE PRESCHOOL CENTER		FACILITY NUMBER:	304371282
ADMINISTRATOR:	WARNER, CHRIS		FACILITY TYPE:	850
ADDRESS:	2780 EAST WAGNER AVENUE		TELEPHONE:	(714) 630-0733
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY:	30	CENSUS: 0	DATE:	09/24/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Rayleen Tafoya-Owner/Director		TIME COMPLETED:	11:30 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	A pre-licensing inspection was conducted today by Licensing Program Analysts (LPAs) Andrea Taylor, Jordann Nelson and Tina Nguyen to inspect and measure facility for capacity determination. The proposed program will operate Monday - Friday 7:00AM - 6:00 PM. Applicant is seeking to provide care for Preschool children age 2-6. LPAs toured the entire facility indoors & outdoors and the following measurements were taken: Indoor Activity Space Room #1: 457 div. 35 = 13 Room #2 457 div. 35 = 13 Room #3: 423 div 35 = 12 Total indoor space= 1337 div 35= 38 children Total children toilets and sinks: 6 toilets x 15 = children = 90 7 sinks x 15 = children = 105 Total Outdoor Activity: 11083 div. 75 = 148 Based on today’s measurement limiting factor is the fire clearance, the capacity is limited to 30 children. The following was observed: · Classrooms are adequately equipped with age and size appropriate furniture and equipment · Water cooler with cups will be available for inside & outside drink. · Playground is enclosed by appropriate fence. · Outdoor activity area is supplied with age and size appropriate equipment.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: SHINE PRESCHOOL CENTER	FACILITY NUMBER: 304371282
	VISIT DATE: 09/24/2019

NARRATIVE

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Reviewed Certificate of completion for Mandated reporter on file for all staff. http://childcare.mandatedreporterca.com

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative.
English: https//www.cdph.ca.gov/programs/SIDS/Doucments/SIDSchildcaresafesleep.pdf
Spanish: https//www.cdph.ca.gov/programs/SIDS/Doucments/ChildCareProvSleepSPAN2011.pdf

Exit interview was conducted and a copy of this report was provided to the director on this date.

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. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The facility has sent the update plan of operation for providing IMS to our office. 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

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: SHINE PRESCHOOL CENTER	FACILITY NUMBER: 304371282
	VISIT DATE: 09/24/2019

NARRATIVE

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· Adequate shade is provided by the outdoor activity area
· Food preparation area is equipped with refrigerator; sink with hot and cold running water;
storage area; utensils; and adequate amount of food supplies
· The office area is located by the main entrance to the preschool and will temporarily serve as the isolation area for
ill children until parents arrive.
· Medication will be stored in the director's office and is inaccessible to children.
· Medication administration forms were reviewed.
. First Aid kit is complete.
· Sign in/Sign out record was reviewed. Program will be using electronic device for sign in/out.

The following must be corrected prior to a license being issued: Make kitchen area in Room #3 inaccessible,
a barrier placed at the bottom of the stair cases next to classroom 3.

Applicant was advised the children's bedding may not come in contact with other children's cots or bedding.
Applicant was notified about disaster drills, posting requirements, children records, mandated child abuse and injury/ death reporting, SIDS and Never Shake a Baby. Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if serious 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. Applicant has been informed that all employees must be associated to the facility. If the licensee fails to have proof of a fingerprint clearance or fails to associate a previously cleared individual to the facility, a civil penalty of $100.00 per day per person will be assessed. The first violation is subject to the penalty for up to five days. If there is a subsequent violation within a 12 month period, the fine will continue for up to 30 days.

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative.

Proof of immunization against pertussis and measles for all employees/volunteers were reviewed for compliance with SB 792.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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