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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606172
Report Date: 10/29/2021
Date Signed: 10/29/2021 03:24:41 PM

Document Has Been Signed on 10/29/2021 03:24 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:REDEEMER LUTHERAN PRESCHOOLFACILITY NUMBER:
300606172
ADMINISTRATOR:WEISS, MELINDAFACILITY TYPE:
850
ADDRESS:16351 SPRINGDALE STTELEPHONE:
(714) 840-7117
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92649
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 18DATE:
10/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Melinda Weiss, DirectorTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Alanna Gontarek, conducted an on-site visit for the purpose of 1 year required inspection. LPA and director toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 4 preschool staff and 18 preschool children. Due to COVID 19 guidelines, LPA observed staff and children wearing face masks, following Dept of Public Health Guidelines. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:00 a.m.- 5:30 p.m., Monday through Friday.

Director was reminded that all adults 18 and over, 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 director was informed that the Criminal Record Statement (LIC 508) has been updated, and the facility must now use the new form with revised date 7/15. The director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance.

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. Poisons/Hazardous Items are not kept on the premises. Per Director, there are no children with medications at this time. Food is not prepared on site; snacks are provided. Per Director, facility provides snack and parents bring additional snacks as well. Food prep areas were clean and sanitary. At 9:24 a.m., LPA Gontarek observed opened snack items not stored properly from their original containers. LPA observed Toasted Oats cereal opened, and sealed with a piece of clear tape in the Angel Fish Room. At 10:08 a.m., LPA observed cracker box with opened cracker bag rolled down inside. At 10:25 a.m., LPA inspected kitchen and observed one box of Cheeze-Its not sealed properly. There were 3 out of 4 rooms with snack items not sealed properly. Menus were posted where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. At 9:25 a.m.,
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: REDEEMER LUTHERAN PRESCHOOL
FACILITY NUMBER: 300606172
VISIT DATE: 10/29/2021
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LPA Gontarek observed 2 trash cans in the Angel Fish room, 1 trash can in the Dolphins room, 1 trash can in the Rainbow Fish room to not have tight-fitting lids. Per Director, food items are discarded in these trash cans. There were a total of 4 out of 4 trash cans with no tight-fitting lids. There is drinking water available to children indoors by sports bottle with the child’s name on it. The children's bathrooms are clean and sanitary. Children nap on mats, and bedding is stored individually, and per director, she washes sheets and pillow cases at end of week, and blankets are taken home weekly to be washed by parents at end of the week. The facility has conducted an emergency drill within the past six months. Disaster drill, both Earthquake and Fire drill were last conducted on 4/29/21. The facility has a working carbon monoxide detector and fire extinguisher. The fire extinguisher was last serviced on 2/14/2020. Facility met all posting requirements. The California Child Passenger Safety Law was posted by the entrance of the facility

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. The cushioning material (tire chips) was surrounding the climbing equipment, slides and other similar equipment appeared to be enough to absorb falls. Drinking water in the outdoor activity space is provided by sports bottles with the child’s name on it. The outdoor equipment
and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair.

Staff files were reviewed for staff present during the facility inspection on this date, 5 out of 5 staff files were reviewed. Health screening and immunization records as required were reviewed. Proof of immunization against pertussis, measles, and Flu for Director and all staff present during today's visit were reviewed and within compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting 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 7/14/2022. The last Staff Training completed was on 9/7/2021 including: emergency preparedness, sanitation practices, daily COVID-19 Health screening procedure, and daily operation.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 10 of children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021
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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: REDEEMER LUTHERAN PRESCHOOL
FACILITY NUMBER: 300606172
VISIT DATE: 10/29/2021
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or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day. LPA observed all children to be signed in.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov. The director requests 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

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 director 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 Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative. Facility Director does not have lead training Certificate.

Provider Information Notice (PIN) 20-06-CCP regarding Social and Physical Distancing Guidance and Healthy practices for childcare facilities in response to the global coronavirus (COVID-19) pandemic written in collaboration with the CA Department of Education was discussed.

PIN 21-08-CCLD announces the resumption of on-site mandated regular inspections, also known as “annual inspections.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021
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: REDEEMER LUTHERAN PRESCHOOL
FACILITY NUMBER: 300606172
VISIT DATE: 10/29/2021
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Please post/keep this PIN in the facility where parents, authorized representatives, and children in care can easily access it and distribute the Companion Guide PIN Summary for Children in Care Fact Sheet (located at the end of the PIN) to their authorized representative. LPA provided director a copy of the PIN.

Based on LPAs observations, the following violations were observed are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, Article 6 and Title 22, Division 12, Chapter 1, Article 7, are being cited on the attached LIC 809D.

Exit interview conducted and report was reviewed with the facility representative Melinda Weiss, Director. The facility representative 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.

A notice of site visit was given and must remain posted for 30 days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/29/2021 03:24 PM - It Cannot Be Edited


Created By: Alanna Gontarek On 10/29/2021 at 01:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: REDEEMER LUTHERAN PRESCHOOL
FACILITY NUMBER: 300606172

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(f)(1)
Fixtures, Furniture, Equipment and Supplies
(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, at 9:25 a.m., LPA Gontarek observed 2 trash cans in the Angel Fish room, 1 trash can in the Dolphins room, and 1 trash can in the Rainbow Fish room to not have tight-fitting lids. Per Director, food items are discarded in these trash cans. The licensee did not comply with the section cited above in that 4 out of 4 trash cans did not have tight-fitting liids, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2021
Plan of Correction
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Per Director, will replace all trash cans with trash cans that have tight-fitting lids, making sure they are leakproof and rodent proof. Per Director, will submit pictures of the trash cans to the LPA via email by the due date 11/05/2021.
Type B
Section Cited
CCR
101227(a)(1)
Food Service
(1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, at 9:24 a.m., LPA Gontarek observed Toasted Oats cereal opened, and sealed with a piece of clear tape in the Angel Fish Room. At 10:08 a.m., LPA observed cracker box with opened cracker bag rolled down inside. At 10:25 a.m., in kichen, LPA observed one box of Cheeze-Its not sealed properly. The licensee did not comply with the section cited above in that 3 out of 4 rooms had snack items not sealed properly, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/05/2021
Plan of Correction
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Per Director, will discard all open snack items today and will conduct a staff training meeting regarding procedure for properly storing snack and staff items once opened and removed from original containers and labeling expiration dates. Per Director, staff will complete an Online Food Safety Training and submit certificates to LPA via email by the due date . Per Director, will submit meeting notes, agenda, and staff signatures by the due date of 11/5/2021 as well.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Patricia Magana
LICENSING EVALUATOR NAME:Alanna Gontarek
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2021


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