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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270165
Report Date: 11/18/2022
Date Signed: 11/18/2022 02:33:09 PM

Document Has Been Signed on 11/18/2022 02:33 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:ST. ANNE SCHOOLFACILITY NUMBER:
304270165
ADMINISTRATOR:NAVARRO, ESTHERFACILITY TYPE:
850
ADDRESS:1339 S. SYCAMORETELEPHONE:
(714) 542-9328
CITY:SANTA ANASTATE: CAZIP CODE:
92707
CAPACITY: 42TOTAL ENROLLED CHILDREN: 16CENSUS: 15DATE:
11/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Esther Navarro, Site DirectorTIME COMPLETED:
02:45 PM
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On 11/18/2022 Licensing Program Analyst (LPA), Patricia Rivas conducted an onsite visit for the purpose of a 1 year required inspection. LPA and Esther Navarro Site Director toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Census was taken Pre K Room 1 had 13 children and two staff, Rm 2 had 2 children and 1 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:00AM - 6:00 PM ., Monday through Friday.
A review of the Facility Personnel Report Summary conducted on 11/18/2022 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Ms. Navarro 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 children's bathroom is clean and sanitary. Children nap on cots, blankets and sheets are provided if children do not bring them. Blankets and sheets are taken home to be washed. The facility has conducted an emergency drill on 10/20/22. The facility has a working carbon monoxide detector Facility met all posting requirement. 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 ( turf commercially produced for the purpose) around the climbing equipment, swings, slides and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by water cups with the child’s name on it or water jugs provided by facility. 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.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ST. ANNE SCHOOL
FACILITY NUMBER: 304270165
VISIT DATE: 11/18/2022
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Due to time constraints the staff and children files will be reviewed at a later date. The facility will be closed for Thanksgiving Holiday and will reopen on 11/28/22.

During today's visit no Title 22 deficiencies were observed.

Exit interview conducted and report was reviewed with Esther Navarro, Site Director Appeal Rights and were discussed. 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC809 (FAS) - (06/04)
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