304371517-7-20-2021-06-CC-STOE-C54PP6-20210720112902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371517
Report Date: 07/20/2021
Date Signed: 07/20/2021 11:29:15 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:	INTERNATIONAL SCHOOL OF ORANGE COUNTY		FACILITY NUMBER:	304371517
ADMINISTRATOR:	CONWAY, COLLEEN		FACILITY TYPE:	850
ADDRESS:	1838 NORTH SHAFFER STREET		TELEPHONE:	(714) 771-4710
CITY:	ORANGE	STATE: CA	ZIP CODE:	92865
CAPACITY:	38	CENSUS: 0	DATE:	07/20/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Colleen Conway, Director		TIME COMPLETED:	11:45 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	Licensing Program Analyst (LPA) Stacy Torrence conducted an announced on-site pre-licensing inspection for the purpose of a change of ownership. Frederique Bauer will assume ownership of the facility. LPA met with Colleen Conway, Director who guided analyst on a tour of the facility. The facility is not currently operating; therefore, there were no children or staff present, during today’s inspection. The applicant has requested to provide care and supervision for 38 preschool children, ages; 2-5 years old, Monday-Friday, 8:30 a.m. to 5:30 p.m., in classrooms: A1 and A2. 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. Office area is located at the front entrance of the building. The facility’s library will 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. Medication will be stored in the director’s office in a cabinet located behind director’s desk. Medication administration forms were reviewed. First Aid supplies were inspected and are stored in each classroom and in the office. EMSA approved Pediatric CPR & First Aid are current for the director and expires on 07/2023. Facility representative completed the 8-hour Preventative Health Practices and Nutrition Course with A-B-CPR on 08/2017. Lead Poisoning Prevention Training Course completed on 08/2020. 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 Continue on next page (1 of 5)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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: INTERNATIONAL SCHOOL OF ORANGE COUNTY	FACILITY NUMBER: 304371517
	VISIT DATE: 07/20/2021

NARRATIVE

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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 children bring water bottles from home, each classroom has a water dispenser for refill, and facility have extra water bottles for children in need
· Sign in/Sign out procedure was reviewed and meets regulation requirements
· 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 shall be stored on top of the shelf when not in use
· Bedding will be taken home every Friday by parents to wash and return the following week. Facility also have extra bedding.

Center policy is that lunches and snacks are provided by the parents with nutritional guidelines. Evaluator reviewed Title 22 Sections 101227 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food.

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
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)
· Sudden Infant Death Syndrome Poster (recommended)
· Shaken Baby Syndrome Poste r (recommended)

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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: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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: INTERNATIONAL SCHOOL OF ORANGE COUNTY	FACILITY NUMBER: 304371517
	VISIT DATE: 07/20/2021

NARRATIVE

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The indoor activity space was measured and is as follows:
Room #A1: 29.8 x 23.2 = 691 sqft.
Room #A2: 29.8 x 23.2 = 691 sqft.
Total: 1,382 sqft. divided by 35 = 39 children

Total children toilets and sinks:
Toilets: 3 X 15 = 45 children
Sinks: 4 X 15 = 60 children
Urinal: 1 X 15= 15 children

LPA discussed with the 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. Facility representative was advised the children's bedding must be stored individually and may not touch another children's bedding.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by the children bringing water bottles from home, the facility brings a jug of water outside for refill
· Outdoor activity space is supplied with age and size appropriate equipment, including slide and climbing equipment
· An adequate amount of cushioning material consisting of poured rubber, under the play equipment
· Adequate shade is provided by two shade awning

Total outdoor activity space was measure and is as follows:
Playground: 127 x 47 = 5,969 sqft.
Total: 5,969 sqft. divided by 75 = 79 children

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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: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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: INTERNATIONAL SCHOOL OF ORANGE COUNTY	FACILITY NUMBER: 304371517
	VISIT DATE: 07/20/2021

NARRATIVE

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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

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 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 38.

A license will be issued for the capacity of 38 after a final review. The applicant will be notified if any additional information is required.

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

The facility is in the process of getting their water tested for lead.

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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: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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: INTERNATIONAL SCHOOL OF ORANGE COUNTY	FACILITY NUMBER: 304371517
	VISIT DATE: 07/20/2021

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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 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: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

LIC809 (FAS) - (06/04)

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