304371526-8-6-2021-06-CC-STOE-C5MTW3-20210806150452

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371526
Report Date: 08/06/2021
Date Signed: 08/06/2021 03:05:01 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:	LHC LAMBEES PRESCHOOL		FACILITY NUMBER:	304371526
ADMINISTRATOR:	DANG, ANNE MARIE H.		FACILITY TYPE:	840
ADDRESS:	12211 MAGNOLIA STREET		TELEPHONE:	(657) 232-3445
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92841
CAPACITY:	30	CENSUS: 0	DATE:	08/06/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Grace Le, President		TIME COMPLETED:	02:15 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) Stacy Torrence conducted an onsite prelicensing inspection at this proposed childcare center. Applicant has requested to change location from 920 N. Bewley, Santa Ana to 12211 Magnolia Street, Garden Grove. LPA met with President, Grace Le who guided analyst on a tour of the center. Applicant/Director Anne Marie Dang arrived at the inspection at 12:00 p.m. The facility representative has requested to provide care and supervision for 30 school-age children; ages 5 to 17 years of age; Monday through Friday, 3:00 p.m. to 6:00 p.m. In classrooms: 5 and 6. 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. Director’s office area is located in the front portion of the facility next to the entrance and 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 the top file cabinet. Medication administration forms were reviewed. First Aid supplies were inspected and are stored in each classroom and director. EMSA approved Pediatric CPR & First Aid are current for the director and expires on 02/23. Facility representative completed the 8-hour Preventative Health Practices and Nutrition Course with A-B-CPR and Lead Preventative Training has not been completed. 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 4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: LHC LAMBEES PRESCHOOL	FACILITY NUMBER: 304371526
	VISIT DATE: 08/06/2021

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 water dispenser and disposal cups
· 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

Center policy is to provided breakfast, lunch, PM snack. 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)

The indoor activity space was measured and is as follows:
School-Age Room 5: 49.03 x 24.10= 1,181 sqft
School-Age Room 6: 14.06 x 11.05= 155 sqft
Total= 1,336 sqft divided by 35 = 38 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: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: LHC LAMBEES PRESCHOOL	FACILITY NUMBER: 304371526
	VISIT DATE: 08/06/2021

NARRATIVE

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Total children toilets and sinks:
Toilets: 4 x 15 = 60 children
Sinks: 4 x 15 = 60 children
Urinals: 2 x 15 = 30 children

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/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 water dispenser and disposal cups
· Outdoor activity space is supplied with age and size appropriate equipment, climbing equipment, and swings
· An adequate amount of cushioning material consisting of woodchips is place under the play equipment
· Adequate shade is provided by mature trees
There is no bodies of water on the premises

Total outdoor activity space was measure and is as follows:
School-Age Playground: approx. 9,200 sqft.
Total: approx. 9,200 sqft divided by 75 = 122 children

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

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 indoor and outdoor activity space to support the capacity of 30.

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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: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: LHC LAMBEES PRESCHOOL	FACILITY NUMBER: 304371526
	VISIT DATE: 08/06/2021

NARRATIVE

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Fire clearance granted on 08/03/2021.

Prior to licensing the following documents must be submitted to the licensing office by the due date of 08/13/2021:
1. Applicant need to complete the required Lead Poisoning Training.

The facility representative will be notified if any additional information is required. After final review a license will be issued.

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: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC809 (FAS) - (06/04)

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