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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622007
Report Date: 09/21/2021
Date Signed: 09/21/2021 01:59:33 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:ICONIC KIDS CHILDCARE & LEARNING CENTERFACILITY NUMBER:
343622007
ADMINISTRATOR:KUDUPUDI, VASUBABUFACILITY TYPE:
830
ADDRESS:6035 MAIN AVENUETELEPHONE:
(916) 542-7196
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:8CENSUS: 1DATE:
09/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Iona ThompsonTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPAs) Kelly Ferrara and Michelle Pascual met with Director Iona Thompson for an unannounced annual inspection on September 21st, 2021. At 10:45 AM, LPAs toured the facility including all activity and classroom spaces, restrooms, food service and outdoor play areas. Appropriate ratio and care and supervision were observed during today's inspection. Census included one infant child being supervised by one staff. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Facility hours of operation are Monday through Friday from 7 AM to 5 PM.

LPAs observed a current Needs and Services plan in each infant's file. LPAs provided technical assistance regarding Infant Sleeping Plan (LIC9227) for each child under 12 months of age and sleep checks every 15 minutes for all children under two. LPA observed that all cribs were free of loose articles or objects and there was one crib or mat for each child in care with a tight fitted sheet. All furnishings were in good condition. Staff stated that the bedding is changed daily. Infant diaper changing area is clean and within arm's reach of a sink. There is a one inch thick mat for the changing table with a vinyl surface. Toys are appropriate size with no small parts for the safety of the infants.

Classrooms all appeared clean including the carpets and floor. Chemicals were kept inaccessible to children in a locked cabinet. Playground equipment and surfaces were inspected and are in good condition with enough resilient material under climbing structures to absorb a fall. Uncontaminated drinking water was readily available to children both indoors and outdoors. Bathrooms were clean and all sinks and toilets were in operating condition. There are no firearms or bodies of water on the premises and the facility has at least one functioning smoke and carbon monoxide detector. LPAs observed all required licensing documentation was posted for parental review. LPAs observed that parents are signing their children in and out of the center. LPAs discussed current Covid guidelines with the Director.

Continued on 809-C

SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: ICONIC KIDS CHILDCARE & LEARNING CENTER
FACILITY NUMBER: 343622007
VISIT DATE: 09/21/2021
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At 12 PM, children and staff files were reviewed. Each child's file had the required licensing documentation. LPAs reviewed staff transcripts and observed all staff caring for infants were qualified. At least one staff had a current Pediatric CPR and First Aid certification. Staff all have current Mandated Reporter certificates and proof of immunizations. LPAs observed a current children's roster and a fire drill log. There is First Aid equipment available.

Incidental Medical Services (IMS) are provided by this facility. For additional IMS information, Director was advised to see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

The facility evaluation report was reviewed and discussed with the Director. Director was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, PINs, forms, regulations and legislation pertaining to child care centers.

A notice of site visit was provided and should remain posted for a period of 30 days for parental review. There were no citations issued based on today's inspection.

SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
LIC809 (FAS) - (06/04)
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