300602295-3-10-2025-06-CC-AFCN-DEMTK3-20250310144716

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300602295
Report Date: 03/10/2025
Date Signed: 03/10/2025 02:47:26 PM

Document Has Been Signed on 03/10/2025 02:47 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	HEPHATHA LUTHERAN CHURCH PRESCHOOL		FACILITY NUMBER:	300602295
ADMINISTRATOR/ DIRECTOR:	MORA, TERI		FACILITY TYPE:	850
ADDRESS:	5900 E SANTA ANA CANYON RD		TELEPHONE:	(714) 637-0887
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY: 97	TOTAL ENROLLED CHILDREN: 97	CENSUS: 55	DATE:	03/10/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:10 PM
MET WITH:	Director Teri Mora		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

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On 03/10/2025 at 12:10pm, Licensing Program Analyst (LPA), Anna Chan conducted an unannounced onsite inspection for the purpose of an Annual Random visit. LPA met with Director Teri Mora. LPA and Director toured the facility inside and outside and the floor and yard plan were verified. Census was taken in individual classrooms. The overall census observed was 55 preschool children and 6 staff.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7a.m.- 5p.m., Monday through Friday. The facility has 4 types of programs: Half Day 7am-12:30pm, Half Day 8:45am-12:30pm, Part Day 8:45am-3:00pm and Full Day 7am-5pm.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Food is brought from home. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by water jugs and water from refilling station and sports bottle are also brought by children from home with the child’s name on it.The children's restrooms are clean and sanitary. Children nap on mats, and bedding are stored individually. Beddings such as blankets and sheets are brought home weekly for washing or the last day the child is in school.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HEPHATHA LUTHERAN CHURCH PRESCHOOL	FACILITY NUMBER: 300602295
	VISIT DATE: 03/10/2025

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The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The cushioning material is rubber black top around the climbing equipment, such as slides, and other similar equipment appeared to be enough to absorbs falls. There is also a part of the playground that has sand area and some areas have turf. The surface of the outdoor activity space was well maintained and free of hazards. Drinking water in the outdoor activity space is provided by water refilling station and sports bottles with the child’s name on it. There are no bodies of water present at the facility.

The facility has a working carbon monoxide detector and fire extinguisher. The facility has conducted an emergency drill on February 19, 2025. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility

5 Staff files were reviewed for staff present during the facility inspection on this date. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1596.7995 (a)(1) a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.

Proof of immunization against pertussis, measles for the facility were reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporter training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 8/2026.

5 Children's records were reviewed, and there was a separate, complete and current record for each child. Sign in/out procedure was reviewed. In the areas reviewed, the children’s files were found to be in full compliance.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HEPHATHA LUTHERAN CHURCH PRESCHOOL	FACILITY NUMBER: 300602295
	VISIT DATE: 03/10/2025

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Currently, there are medications at the facility. This facility provides Incidental Medical Services (IMS) LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information 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

Transfer Request (LIC9182). The Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov and may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov

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

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

An Inspection and exit interview were completed with Director Teri Mora. The report was reviewed and discussed. Appeal Rights were discussed. The director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

Notice of Site Visit was posted. Notice of Site Visit must remain posted for 30 consecutive days.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

LIC809 (FAS) - (06/04)

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