304371482-1-12-2021-06-CC-STOE-BX428N-20210108161037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371482
Report Date: 01/08/2021
Date Signed: 01/12/2021 09:09:38 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:	OAKCREST HEAD START		FACILITY NUMBER:	304371482
ADMINISTRATOR:	CHAVEZ, SUSANA		FACILITY TYPE:	850
ADDRESS:	22733 OAKCREST CIRCLE		TELEPHONE:	(714) 241-8920
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92887
CAPACITY:	40	CENSUS: 0	DATE:	01/08/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Alma Lopez, Education Manager		TIME COMPLETED:	12:00 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) Stacy Torrence conducted an on-site pre-licensing inspection at this proposed Head Start childcare center. LPA met with, Alma Lopez, Education Manager and Susana Chavez, Site Supervisor and toured center. The facility representative has requested to provide care and supervision for children 2 to 5 years of age, Monday-Friday 7:30 a.m.-5:30 p.m., in classrooms #1 and #2. Applicant is seeking to provide care for 40 preschool children. The school is under the Orange County Head Start program. 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 Site Supervisor office area is located within classroom #2 and will serve as the isolation area for ill children temporarily until parents arrive. The staff/adult bathroom will be used as the isolation bathroom for ill children and is conveniently located to the isolation area. Medication will be stored in each classroom, located in a medical backpack with a combination lock. Medication administration forms were reviewed. Additional training will be provided to the teachers for administration of medication and treatment. First Aid supplies were inspected and are stored in each classroom in backpack. EMSA approved Pediatric CPR & First Aid are current for the site supervisor and expires on 11/20. Site Supervisor completed the 8-hour Preventative Health Practices and Nutrition Course dated 09/20. Site Supervisor completed Lead Poisoning Preventive Course on 12/20. Due to current Pandemic situation, all COVID guidelines are being implemented. Upon entering the facility children's temperatures will be checked and hands shall be sanitized before entering the classrooms. Visitors are not allowed at this time. Continue on next page (1 of 4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

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: OAKCREST HEAD START	FACILITY NUMBER: 304371482
	VISIT DATE: 01/08/2021

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside by utilizing a Brita water dispenser; with disposable cups
· 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
· Napping equipment shall be stored in the corner of each classroom when not in use

Food Services: Food is prepared at the Orange County Head Start Center and is delivered to the facility. The facility will be providing breakfast, lunch and PM snack.

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

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SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: OAKCREST HEAD START	FACILITY NUMBER: 304371482
	VISIT DATE: 01/08/2021

NARRATIVE

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The indoor activity space was measured and is as follows:
Room # 1: 31.0 x 26.7 = 828.00 sq. divided by 35= 23 children
Room # 2: 36.9 x 32.3 = 1191.87 sq. divided by 35= 34 children

Total: 2019.87 sq. divided by 35 = 57 children

4 sinks = 120 children
4 toilets= 60 children

Fire clearance approved on 11/24/2020, for requested capacity of 40 children.

The facility has one bathroom with 4 sinks and 4 toilets.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available inside by utilizing a Brita water dispenser; with disposable cups
· Outdoor activity space is supplied with age and size appropriate equipment
· An adequate amount of cushioning material consisting of rubber form is in place under the play structures
· Adequate shade is provided by covered patio and an umbrella

The outdoor activity space was measured and is as follows:
Playground 52 x 31 = 1612 sq. divided by 75 = 21 children

Facility representative is requesting a waiver for a rotating outdoor activity schedule. Waiver request given to LPA today during the visit.

The facility is in the process of completing the required Water testing.

The facility representative 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

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SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: OAKCREST HEAD START	FACILITY NUMBER: 304371482
	VISIT DATE: 01/08/2021

NARRATIVE

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Facility representative was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to download forms, Title 22 regulations, and trainings 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 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 40. A license will be issued for the capacity of 40 after a final review. The applicant will be notified if any additional information is required.

Facility representative 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, and the report shall be 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. 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 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

End of Report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

LIC809 (FAS) - (06/04)

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