<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371547
Report Date: 05/27/2022
Date Signed: 05/27/2022 01:55:31 PM


Document Has Been Signed on 05/27/2022 01:55 PM - It Cannot Be Edited

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:ORANGE TREE CHRISTIAN PRESCHOOLFACILITY NUMBER:
304371547
ADMINISTRATOR:JUNG, CHRISTINEFACILITY TYPE:
850
ADDRESS:2115 NEWPORT BLVD.TELEPHONE:
(949) 458-1382
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY:72CENSUS: 0DATE:
05/27/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Owner Ms. Leslie, Lucy 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) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a New center. LPA met with the Owner/ Applicant Ms. Leslie Lucy who gave a tour of the Child Care Center on the premises of The Crossing Church. Three rooms and outdoor play yard is designated to the Child Care Center.

The applicant has requested to provide care and supervision for 60 Pre-school age children 2 to 6 years of age, Monday through Friday 7:30 AM. to 6.00 PM. in the assigned three classrooms. (Room # 101, 102 and 103)

LPA observed staff following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements, children shall be received at the entrance door of each classrooms by the staff. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities. Parents sign them electronically using an application called Pro-Care.

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 is on the premises of The Crossing Church in a separate building across Armstrong gardening store, with parking area for parents. The entrance door is the only access door to enter the Preschool premises, parents shall use an electronic application scan to enter the main entrance of the center upon entering the facility through the glass door, there is a front lobby area, and one classroom is located on the left hand side while the other two classes are at the end of the lobby. There is also an additional double door which shall remain open during drop off and pick up times for parents to access the classrooms. (1)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 05/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/27/2022
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 5


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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 05/27/2022
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
Isolation area is the Director’s office, located on the first level and the sick child shall use the restroom located next to the lobby area there is an additional cots with linens for the sick child.

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) & · COVID Posters.

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 through personalized water bottles and water dispenser and water pitchers in each preschool rooms.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Electronic sign in and out)
· Facility has built in smoke detector, carbon monoxide detector, along with Sprinkler system and fire extinguishers in each classrooms 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 on top of the cubbies, mounted on the wall, napping linens and blankets are provided by the parents, facility also has additional linens if needed.
· Facility provides AM/PM snacks, lunch is brought from home. This containers are labelled and stored in the individual cubbies.
Rooms are well lighted with proper ventilation
Each room has age appropriate activity items and space to move around.
Room # 103 has a changing table along with small baby toilet and is designated for younger Preschool age children between 2-3 only. (2)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 05/27/2022
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 measured the three assigned Preschool rooms

Indoor activity space : 2071'58 divided by 35 = 59 ( 60 children)
Facility has sufficient indoor activity space to accommodate the requested capacity of 60 children.

Total sinks : 18 X 15= 270 children / Total Toilets: 25 X 15= 375 children

Facility has age appropriate sinks and toilets in the classrooms and adjoining the outdoor play area.

Preschool outdoor play yards : Facility has designated Preschool yards and following was observed:


· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water fountains and personal water bottles
· 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 consisting artificial turf is in place under the play structure
· Adequate shade is provided by shaded structure (Canopy)and roof line shade.
· There is also a bike trail area and a cemented open area for children to play. Younger preschool children shall use buggy carts to access the play yard. While older preschool children shall walk to the play yard.
Children and staff shall walk through the outdoor area to access the play yard, located across the preschool building.
It has two exit doors with electronic key pad to gain access to the play yard. Facility also has an alarm system installed on it, if the door is opened accidentally from inside. The inside push handle is at an appropriate height not reachable to the child.
The play structure on the artificial grass, shall be accessed only for ages 5 and above children. It has a label indicating that the play structure is for ages 5-12 years only. Applicant has installed safety gates at the access points on the play structure.
There are three areas on the play yard for children: Bike trail/ sandbox area / open space where additional structures are placed for younger children.
There are bathrooms with sinks adjoining the play yards.
Shaded lunch area has been set up for outdoor lunch activity. (3)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 05/27/2022
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
Total outdoor activity space: 4808'06 divided by 75 = 64 children.

Based on the indoor and outdoor measurements, sink and toilet availability, facility has sufficient space to accommodate the requested capacity of 60 Preschool age children (2-6 years old) in the assigned three classrooms.

Fire clearance received from Costa Mesa Fire Authority approving the requested capacity of 60 children
in the three rooms.

Applicant Ms. Leslie Lucy is current on the required Immunization/ Pediatric CPR/ First training valid through July 23rd 2023 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component and Mandated Child abuse reporting training.

Following items were discussed at the time of Exit interview.
Criminal Record Statement : Applicant, Ms.Leslie, Lucy 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.

Safe Sleep : LPA discussed the safe sleep regulations with applicant Ms. Leslie, Lucy 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.

(4)

SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 05/27/2022
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
Incidental Medical Services (IMS) APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated 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

Review of records to be maintained

Child Care Centers :LPA reviewed with applicant, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Subscribe to CCLD important information

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 license-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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A license for 60 Preschool age children (2-6 years) in three assigned classrooms # 101/ 102 and 103. Monday to Friday 7.30 am to 6.00 PM, shall be issued upon management approval.



Report read and appeal rights presented to the applicant.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5