304371282-2-2-2021-06-CC-KDEI-BXUU2E-20210202141148

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371282
Report Date: 02/02/2021
Date Signed: 02/02/2021 02:11:55 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:	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: 26	DATE:	02/02/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Director Tafoya Rayleen		TIME COMPLETED:	02:30 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	A case management Licensee initiated unannounced inspection was conducted on this date by LPA Ketki Desai. The purpose for today’s inspection was to evaluate the facility for a capacity increase as requested by the Licensee. LPA met with director Ms. Tafoya Rayleen, who gave the tour of the three classrooms and the outdoor play yard. Facility is currently licensed for 30 children and seeking to increase capacity to 36 children ages from 2 to 6 years of age, Monday through Friday, 7.00 AM to 6.00 PM. The program will continue to use the assigned rooms (Room # 1,2 and 3) located in the lower level of the facility. All areas identified on the Facility Sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Storage for children's belongings and an isolation area with sink, toilet, and mat/cot were inspected. Availability of drinking water was reviewed. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. First Aid supplies were inventoried. 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 place under the equipment. Shade is provided by awnings and a Water pitcher and personnel water bottles are used for drinking water. A review of medication policy, including administering, labeling, storage, and records were made, disaster drills, posting requirements, children records, mandated child abuse and injury/death reporting, and criminal records clearances/exemption transfer requests, SIDS and Never Shake a Baby complete.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

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: 02/02/2021

NARRATIVE

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All the 3 Preschool rooms were measured today:

Room # 1: 30’83 X 14’33 = 441’79
Room # 2: 30’92 X 14’42 = 445’87
Room # 3: 27’92 X 14’ 58= 407’07

Total indoor capacity: 1294’73 divided by 35 = 36.99 (37 children)

Total sinks= 7 x 15= 105
Total urinals (2) and (4 stalls) = 6 x15= 90

Outdoor: Facility has enough outdoor space for the requested capacity of 36 children.

Play yard: 152’50 X 36’67 = 5592’18 divided by 75 = 74.56 (75 children)

Fire clearance from the Anaheim Fire Prevention Authority has been received on 1/12/21 and approved for requested capacity of 36 children.

Based on today’s measurement indoor and outdoor with sink & toilet availability, center has enough activity space to support the requested capacity of 36 children.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

After a tour of the center, no deficiency was observed. File will be submitted for approval as of today.

Exit interview conducted. Notice of Site Visit was posted. Facility representative 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. “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.”

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

LIC809 (FAS) - (06/04)

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