304371444-10-22-2020-06-CC-KDEI-BUMSJD-20201022135458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371444
Report Date: 10/13/2020
Date Signed: 10/22/2020 01:55:20 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:	MERRY HIVE		FACILITY NUMBER:	304371444
ADMINISTRATOR:	WILLAME, ROSE		FACILITY TYPE:	850
ADDRESS:	23802 AVENIDA DE LA CARLOTA		TELEPHONE:	7148723008
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	30	CENSUS: 0	DATE:	10/13/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator Melnik, Svetlana		TIME COMPLETED:	01:15 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	Licensing Program Analyst (LPA) Ketki Desai conducted an announced on site pre licensing inspection at this proposed child care center. LPA met with Facility Administrator Ms. Melnik,Svetlana and toured the new center. The applicant has requested to provide care and supervision for children 2 to 6 years of age, Monday through Friday, 8.00 am. to 6.00 PM, in the two assigned rooms (Room # 104 and 102) on the premises of St George Episcopal Church. The left wing is assigned to a Japanese Preschool (Futaba Preschool ) and right wing with two classroom has been assigned to the new preschool. A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility is located on the first level of the Church, it has a main entrance door which remains locked and has an electronic access code to gain entrance into the facility. Facility Administrator indicates due to pandemic situation no parents are allowed into the facility, there is a reception area and the children shall be received by the facility staff upon entrance and parents shall sign in the children at the entrance. There is sign in table on the right side upon entrance where parents shall sign in manually and the staff shall guide the children to their assigned classrooms. Director‘s office is located across Room # 102. Director's office shall serve as the isolation area for ill children temporarily until parents arrive. The staff/adult restroom will be used as the isolation restroom for ill children and is conveniently located to the isolation area. EMSA approved Pediatric CPR & First Aid are current for the Administrator and expires in (September 2022) . Applicant have completed the 8-hour Preventative Health Practices and Nutrition and Lead Course. Facility has also provided a copy of the recent Water testing certificate, which indicates the facility has safe drinking water.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020

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: MERRY HIVE	FACILITY NUMBER: 304371444
	VISIT DATE: 10/13/2020

NARRATIVE

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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 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

The following were inspected in the indoor activity space:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside by filtered water pitchers for each classrooms.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements
· Cubbies available for storage of individual child’s personal belongings and/or bedding in each classroom
· Napping equipment shall be stored in individual cubbies when not in use and cots shall be used. Linens are to be provided by the parents and washed on a weekly basis by the parents.
Center shall be providing the daily snacks for the children, there is kitchen area. Snacks shall be prepared in the kitchen area and would be taken to each classroom. Storage area was equipped with refrigerator and cabinets. Dry snacks shall be stored in air tight containers. The kitchen area shall be locked inaccessible to children. Evaluator reviewed Title 22 Sections 101227 and 101327 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food. Lunch shall be brought from home and the containers shall be labelled and stored appropriately.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A) (Page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020

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: MERRY HIVE	FACILITY NUMBER: 304371444
	VISIT DATE: 10/13/2020

NARRATIVE

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· Menus
· Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies
· Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)

The indoor activity space was measured and is as follows: Preschool rooms
Room # 104: 29.5 x 19.5 = 575.25- 28.44 = 546.82
Room # 102: 29.5 x 19.25= 575.25- 28.44 = 546.82

Total indoor space : 1093.63 divided by 35 = 31.25

Sinks : 2 x 15= 30
Toilets: 2 x15= 30

LPA discussed with the applicant/facility representative that all employees must have criminal record clearances associated to the facility prior to their presence in the facility, staff to child ratio requirements, direct visual supervision requirements, emergency/disaster drills, children records, mandated reporter training, and staff immunization requirements against measles, pertussis, and influenza. Applicant was advised the children's bedding must be stored individually and may not touch another children's bedding.
Total outdoor activity space : The facility has an open outdoor yard, it is completed fenced from all the sides, with concrete flooring, there are two shaded areas ( Covered sand box area) and a covered Gazebo providing additional shade. Age appropriate outdoor toys were observed. There is one climbing structure and swing set for the children.

Outdoor measurements were as follows : 194 x 46= 8924 divided by 75= 118.99

A Waiver request has been submitted for a shared staggered schedule in-between the two preschools licensed by the Department.
(Page-3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020

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: MERRY HIVE	FACILITY NUMBER: 304371444
	VISIT DATE: 10/13/2020

NARRATIVE

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The applicant was given a pamphlet on Lead Exposure and was discussed with provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf

Applicant was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to down load forms, Title 22 regulations, and training's on-line at www.ccld.ca.gov. The applicant/facility representative was also informed to visit the website for Quarterly Updates. The applicant was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. or at www.ccld.ca.gov

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The applicant/facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness

The facility was in compliance with Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has sufficient activity space to support the capacity of 30 ( Preschool children) . A license will be issued for the capacity requested after a final review. The applicant will be notified if any additional information is required.

Orange County Fire Authority has granted the requested capacity for 30 preschool children age 2-6 years old.

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 (LIC 809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed, and the report shall posted and copies provided to the parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months.

(Page-4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020

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: MERRY HIVE	FACILITY NUMBER: 304371444
	VISIT DATE: 10/13/2020

NARRATIVE

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In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

An exit interview was completed.

The report was reviewed and discussed. Appeal Rights were discussed. The applicant 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: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2020

LIC809 (FAS) - (06/04)

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