304371498-8-17-2021-06-CC-KDEI-C5YRSQ-20210817131709

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371498
Report Date: 08/17/2021
Date Signed: 08/17/2021 01:17:25 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:	FREE CHAPEL PRESCHOOL		FACILITY NUMBER:	304371498
ADMINISTRATOR:	ANDERSON GRETCHEN		FACILITY TYPE:	850
ADDRESS:	2777 MCGAW AVENUE		TELEPHONE:	(949) 752-6004
CITY:	IRVINE	STATE: CA	ZIP CODE:	92614
CAPACITY:	110	CENSUS: 0	DATE:	08/17/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Ms.Anderson Gretchen		TIME COMPLETED:	01:45 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) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a New Center on the Church Premises. LPA met with Facility Administrator Ms. Anderson Gretchen, who gave a tour of the Child Care Center. The applicant has requested to provide care and supervision for 101 Preschool age children (2- 5 years) , Monday through Friday 7.00 am. to 6.00 PM. in the assigned eight classrooms. Facility shall offer a Full day/Half day and Extended care to the children. Due to COVID 19, LPA observed staff wearing face mask, social distancing and following CDC and Dept of Public Health Guidelines. 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 has a huge parking lot for parent drop off and pick up, there is entrance gate where the children shall be received by the staff and parents shall sign them in electronically on a tablet. There is a table set up at the entrance where, facility staff shall check their temperature, sanitize their hands and staff shall walk them to the restroom to wash their hands before they are taken to the classroom. Due to COVID Pandemic parents are encouraged to follow the CDC and COVID requirements, children are received at the entrance door by the staff. There is a door at the end of the lobby, which needs a code to enter, children shall be walked to the their classrooms by the staff, the hallways has classrooms on each side with the Director's office also located in the hallway. The classrooms are well lighted with age appropriate furniture and each classroom has sufficient storage space for toys, while personal items shall be stored outside the classrooms on a wall mounted cubbies. (Page-1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: FREE CHAPEL PRESCHOOL	FACILITY NUMBER: 304371498
	VISIT DATE: 08/17/2021

NARRATIVE

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Medication will be stored in the Director's office in a locked cabinet or if needed in the refrigerator and shall be administered by the Director or the Assistant Director, Emergency First Aid kits are stored in each classrooms and are hung on the wall for immediate access. Medication administration forms were reviewed.
Isolation area is the Director’s office and the sick child shall use the restroom located in the lobby area, there is additional mat and linens for the sick child.

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 through water Dispenser with disposable cups, as well as personal water bottles
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Electronic 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
· Napping equipment: Mats are used and are stored at the end of the hallway in an area inaccessible to children. Napping linens and blankets are provided by parents and are taken home for wash on a weekly basis.
· Facility shall provide Early morning snack and late evening snack to children enrolled in Extended care program, daily AM/PM snacks to Full day and Half day enrolled children. Facility has a Hot lunch program where the parents have an option to purchase them or the children can bring in their own lunch. There is one refrigerator and one freezer, in the teacher's common area where snacks are stored
Each room has a sink for immediate hand washing activity .
* Restrooms are located in separate lobby area where the kids shall be walked over by the staff.
Younger children (2's) have a changing station in the classroom and facility also have Potty chairs as toilet training shall be provided to the younger 2's.

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) / (Page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: FREE CHAPEL PRESCHOOL	FACILITY NUMBER: 304371498
	VISIT DATE: 08/17/2021

NARRATIVE

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Personal Rights (LIC 613A)
· 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) and COVID Posters

All the posters are posted in the lobby area, where parents sign in.

Indoor Measures ( Eight classrooms )

ROOM IDENTIFICATION	LENGTH	WIDTH	AREA	ENCUMBERED	SPACE
Two's room (extra)	17.25	18.58	320.51	4.18	316.33
Two's room (extra) small area	13.17	12.06	158.83	0.00	158.83
Two's A (large area)	29.08	14.5	421.66	4.18	417.48
Two's A (small area)	15.33	4.5	68.99	0.00	68.99
Two's B	25.5	13.58	346.29	4.18	342.11
Three A	38.25	21.5	822.38	4.18	818.20
Three B	27.5	13.5	371.25	4.18	367.07
Four A	30.25	31.25	945.31	4.18	941.13
Four B	27.5	13.5	371.25	4.18	367.07
Fives	27.5	13.5	371.25	4.18	367.07

Total Indoor Measurements: 4164'27 divided by 35 = 118'98 ( 119 children)

Total sinks: 16 X 15= 240 (children) / Total Toilets: 7 X 15= 105 (children)
There are sufficient toilets and sinks in the facility to accommodate the requested capacity (101 children)

Toilets and sinks were observed to be age appropriate. Bathrooms were clean and accessible to children. There are designated bathrooms for Girls and Boys.

(Page-3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: FREE CHAPEL PRESCHOOL	FACILITY NUMBER: 304371498
	VISIT DATE: 08/17/2021

NARRATIVE

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The following were inspected in the Outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water Dispenser with small disposable cups/ Personal Water bottles.
There is one hand washing sink in the play yard.
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor activity toys,
· An adequate amount of cushioning material (artificial grass) is placed under the climbing structures to absorb the falls
· Adequate shade is provided by shaded structure (Canopy)and folding umbrella's
· The yard will be assessed through door, through the walkway passage. This door is locked and is accessed by the staff through the special lock pad scanning card. There are two doors (one for Exit and one for Entrance)

Outdoor Yard Measurement: 127'5 X 34'83 = 4440'83
Total Outdoor space : 4440'83 divided by 75 = 59'21 ( 59 children)

An outdoor yard is limited only to 59 children at a time, hence Facility Director has submitted the request for a rotating schedule to accommodate the requested capacity.

Based on the indoor measurements, sink and toilet availability, facility has enough space to accommodate the requested 101 Preschool children ( 2-5 years old) in the assigned eight classrooms.

Fire clearance received from Orange County Fire Authority dated 7/1/21 have approved the requested capacity of 110 ( Later changed by the facility to 101 per City requirements) in the assigned eight classrooms

Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through
8/2023 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component)
Water Analysis has been completed by the facility and the report is on file. (Page-4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

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: FREE CHAPEL PRESCHOOL	FACILITY NUMBER: 304371498
	VISIT DATE: 08/17/2021

NARRATIVE

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LPA discussed with the applicant 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.

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 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

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

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

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 (Page-5)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: FREE CHAPEL PRESCHOOL	FACILITY NUMBER: 304371498
	VISIT DATE: 08/17/2021

NARRATIVE

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The facility was following Title 22 requirements at the time of the inspection. Based on today’s Indoor measurements, sink and toilet availability, this center has enough activity space to support the capacity of 101 Preschool children, ages 2-5 years old in the eight assigned rooms.
(Two's room /Two A/ Two B /Three A / Three B /Four A / Four B and Fives classroom . Facility have submitted a waiver for outdoor rotating schedule.

A license will be issued for the capacity of 101 preschool children age 2-5 years old, after a final review. The applicant will be notified if any additional information is required.

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, 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. 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: 08/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021

LIC809 (FAS) - (06/04)

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