304371539-1-13-2022-06-CC-KDEI-CAMS6H-20220113123559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371539
Report Date: 01/13/2022
Date Signed: 01/13/2022 12:36:21 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:	STANTON EARLY HEAD START		FACILITY NUMBER:	304371539
ADMINISTRATOR:	JONES, JANIS		FACILITY TYPE:	830
ADDRESS:	8050 CHAPMAN AVENUE		TELEPHONE:	(714) 230-3814
CITY:	STANTON	STATE: CA	ZIP CODE:	90680
CAPACITY:	8	CENSUS: 0	DATE:	01/13/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Facility Administrator Ms. Jones, Janice		TIME COMPLETED:	12:45 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) Ketki Desai conducted an on site pre licensing inspection at this proposed new Infant room. LPA met with Facility Director Ms. Jones, Janis and toured the new Infant room. The applicant has requested to provide care and supervision for Infants New Born to 2 years in the designated one infant classroom, Monday through Friday, 7:30 am. to 5:30 PM. Facility is adding the Infant program in Room # 1. Facility is a Head Start program and follows Title 22 and Title 5. 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 parents and infants shall have access through the main entrance of the facility and shall sign at the classroom entrance, where the teachers shall receive the infants, temperatures will be checked, visual checks along with verbal checks shall be completed, hands shall be sanitized before they are taken to their classrooms. Parents sign them in at the entrance manually. Facility has COVID Guidelines and posters posted in the facility. 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-1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 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: STANTON EARLY HEAD START	FACILITY NUMBER: 304371539
	VISIT DATE: 01/13/2022

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
26
27
28
29
30
31
32

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
· Shaken Baby Syndrome Poster

The new Infant room # 1 was inspected on today's inspection> Room has a napping area with cribs and older infants shall nap on blue cots. The following were inspected in the indoor activity space:
· Classroom is adequately equipped with age and size appropriate furniture, toys and equipment
· Drinking water is available inside by water pitchers
· 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 for individual child’s personal belongings and/or bedding
· The changing table is within arm’s reach of a sink
· The changing table has padding with raised sides
· Bedding and linens are provided by the facility and washed on premises
· There is a designated napping area surrounded by a 4 ft wall with sufficient infant napping equipment (4 cribs and cots for older infants)
· The infant indoor area is physically separate from the preschool component.
There are two sinks and Two baby toilets in this room.

Center policy: Facility shall provide all the needed items for the infants, including formula / baby food/ diapers/ pull ups/ lotions / wipes/ crib linens/ personal utensils/ bowls. Each infant shall have their own bin to store personal items if brought from home.
Director's office is the Isolation area for sick child and additional linens are available. (Page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

Page: 2 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: STANTON EARLY HEAD START	FACILITY NUMBER: 304371539
	VISIT DATE: 01/13/2022

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
26
27
28
29
30
31
32

Infant room #1 was measured today with following measurements

Room# 1 (Infants): 39'33 X 19'5 - 193'15 = 573'79 (Encumbered: Napping area and storage cabinets)
Total indoor activity area : 573'79 divided by 35= 16'39 (16 infants)
Requested capacity: 8 infants

Total children toilets and sinks: There is a toilet inside the room with 2 stalls and 2 sinks.
Sink : 2 X 15= 30
Toilets: 2 x 15= 30

The following were inspected in the outdoor activity space; The Infant yard is accessed from the classroom door, older infants shall walk the ramp, while younger infants shall be carried by the staff. The yard has two sections: Artificial grass area where outdoor toys are placed and the long cemented area, used for small bicycle rides.
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures
· An adequate amount of cushioning material consisting of artificial green grass placed under the play structures
· Adequate shade is provided by roof top canopy

Total outdoor activity space was measure and is as follows:
Infant yard: 50 X 18 = 900

Total outdoor activity area" :900 divided by 75= 12 Infants.

Based on Indoor / Outdoor / Sinks and Toilet availability facility has sufficient space to accommodate the requested capacity for 8 infants in room # 1.

(Page 3) .

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

Page: 3 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: STANTON EARLY HEAD START	FACILITY NUMBER: 304371539
	VISIT DATE: 01/13/2022

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
26
27
28
29
30
31
32

LPA discussed with the facility Administrator Ms. Jones, Janis, 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 Administrator was advised the infant crib area must be supervised at all times. No infant should be left unattended in the crib area. bedding must be stored individually and may not touch another children's bedding

Facility Administrator Ms. Jones, Janis was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

(Page 4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

Page: 4 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: STANTON EARLY HEAD START	FACILITY NUMBER: 304371539
	VISIT DATE: 01/13/2022

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
26
27
28
29
30
31
32

Safe Sleep

LPA discussed the safe sleep regulations with facility administrator Ms. Jones, Janis and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the applicant/facility representative.

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold.

Review of records to be maintained

LPA reviewed with facility Administrative Ms. Jones, Janis the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted

(Page-5)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

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: STANTON EARLY HEAD START	FACILITY NUMBER: 304371539
	VISIT DATE: 01/13/2022

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
26
27
28
29
30
31
32

Facility Administrator was also informed that Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The facility was in compliance with Title 22 requirements at the time of the inspection.

Fire clearance has been approved by Orange county Fire authority for total capacity of 48 children, (40 Preschool age children in room # 2 and 3, along with 8 Infants in room # 1)

Based on today’s measurements, and the sink and toilet availability, this center has sufficient Indoor activity space to support the capacity of 8 infants as requested

A license will be issued for the capacity of 8 Infants ( Newborn - 2 years) after a final review. Applicant shall be notified if additional information is needed.

Facility Administrator 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

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
Exit interview conducted and report was reviewed with the Facility Administrator Ms. Jones, Janis.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

Page: 6 of 6