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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270915
Report Date: 05/12/2023
Date Signed: 05/12/2023 04:55:55 PM

Document Has Been Signed on 05/12/2023 04:55 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:JESUS' HANDS PRESCHOOLFACILITY NUMBER:
304270915
ADMINISTRATOR:CHOI, SOON JAFACILITY TYPE:
850
ADDRESS:5621 BEACH BLVD.TELEPHONE:
(714) 690-1366
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 20DATE:
05/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Soon Ja ChoiTIME COMPLETED:
05:00 PM
NARRATIVE
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On May 12 of 2023 at 9:00 a.m., Licensing Program Analysts (LPA) Archibaldo Silva and Licensing Program Manager (LPM) P. Magana conducted a Case Management – Other inspection due to deficiencies observed during today's visit. Director Soon Ja Choi assisted LPA and LPM during the visit. LPA toured two classrooms and took census. Census at the time of visit was 20 children (11 children in room 1 and 9 children in room 2). An on-site Facility Personnel Report Summary review on 5/12/23 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Upon arrival, LPA and LPM were greeted by S1. LPA asked to speak to the director. While taking census, LPM observed the children in room two were unsupervised and called LPA. LPA and LPM observed that the 9 children in room 2 were unsupervised for approximately four minutes while setting up tables to celebrate a child’s birthday. S2 walked into room two through the room’s playground door and stated that the children were taking picture in room three and that S2 was helping to walk the children from room two to room three.

At approximately 9:57 a.m., LPA Silva asked the director for the children’s roster. The director provided an incomplete roster. The roster showed 15 children enrolled, many of them with incomplete information. The director added C1 and indicated the enrollment date as 1/23/23. The director stated to have forgotten to add C1 to the roster. LPA asked the director for C1’s file. The director looked for the file for about five minutes but was unable to provide C1’s file. At 3:15 p.m. LPA asked for C1’s file for the second time. The director stated to not have a file for C1. The children’s roster had telephone numbers for parent/guardian.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: JESUS' HANDS PRESCHOOL
FACILITY NUMBER: 304270915
VISIT DATE: 05/12/2023
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At approximately 1:44 p.m., the director walked LPM and LPA to room three. LPA and LPM observed S3 supervising 9 children alone in room three. LPM asked the director who else was in room three supervising the children. The director indicated that S3 was alone supervising the children. S2 walked into room 3 to supervise the children almost as soon as LPA and LPM arrived to the room. At approximately 2 p.m. LPA asked for S3’s file. LPA asked for qualification for S3. LPA and LPM reviewed S3’s file and observed there were no transcripts in file. LPM asked if S3 had any college units. The director stated that S3 had no college units from a U.S. college but has college units from Korea. The LPM asked for the transcripts from Korea. The director stated to not have them.

Based on an LPA’s records review and an interview conducted with Director, the facility is being cited in accordance with California Code of Regulations, Title 22, Division 12 or Division 6 Section(s): 101229(a)(1) Responsibility for Providing Care and Supervision, HSC 1596.841 Current roster of children provided care in facility required, 101221(a) Child's Records, and 101216.2(e) Teacher Aide Qualifications and Duties.

Upon receipt, the licensee shall post and provide copies of this licensing report to parents or guardians of children in care at the facility and to parents/guardians of children newly enrolled during the next 12 months. Licensee shall keep signed copies of LIC9224 (Acknowledgement of Receipt Report) in each child's file. This licensing report dated 5/12/23 shall remain posted for 30 days.

Appeal Rights 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 provided and must remain posted for 30 days. An exit interview was conducted and the report was reviewed with Director Soon Ja Choi. The interview exit was translated to Korean by CDSS staff Jung Mi Han over the phone and discussed this report with Director Soon Ja Choi and Licensee Soon Kil Choi.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/12/2023 04:55 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 05/12/2023 at 04:10 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: JESUS' HANDS PRESCHOOL
FACILITY NUMBER: 304270915

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2023
Section Cited
CCR
101229(a)

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101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision...(1) No child(ren) shall be left without the supervision of a teacher at any time.
Licensee did not meet the above requirement as evidenced by:
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The licensee stated that she will ensure children are not left unsupervised in the future. She explained that today was an exception
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Based on observation, the licensee did not comply with the above regulation in 9 out of 9 children which poses a risk to the health, safety, and personal rights of persons in care. LPA observed 9 children in classroom 2 unsupervised for approximately 4 minutes.
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Type B
05/17/2023
Section Cited
HSC1596.841

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1596.841 Current roster of children provided care in facility required: Each child day care facility shall maintain a current roster of children who are provided care in the facility.

Licensee did not meet the above requirement as evidenced by:
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The licensee stated she will update the roster with all the information required. The licensee will provide proof of correction by the due date via fax at the number provided in the business card.
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Based on records review, licensee did not comply with the above regulation in 1 of 1 children's roster which poses a risk to the health, safety, and personal rights of persons in care. LPA observed the roster had missing children; 39 clients are enrolled in total per licensee.
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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:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


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Document Has Been Signed on 05/12/2023 04:55 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 05/12/2023 at 04:28 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: JESUS' HANDS PRESCHOOL
FACILITY NUMBER: 304270915

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2023
Section Cited
CCR
101221(a)

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101221 Child's Records (a) A separate, complete and current record for each child is maintained in the child care center.

Licensee did not meet the above requirement as evidenced by:
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The licensee stated that she will provide a complete file for C1 by the due date 5/17/23. The file will be available for review at the facility.
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Based on observation and records review, the licensee did not comply with the above regulation in 1 out of 1 child's records, which poses a risk to the health, safety, and personal rights of persons in care. The licensee stated that she did not have a file for C1 after looking for it for a few minutes.
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Type B
05/17/2023
Section Cited
CCR101216.2(e)

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101216.2(e) Teacher Aide Qualifications and Duties: An aide shall work only under the direct supervision of a teacher.

Licensee did not meet the above requirement as evidenced by:
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Based on observation and records review, the licensee did not comply with the above regulation in 1 out of 1 aides present, which poses a risk to the health, safety, and personal rights of persons in care. The LPA observed S3 caring for 9 children alone, without the supervision of a fully qualified teacher.
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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:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


LIC809 (FAS) - (06/04)
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