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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270963
Report Date: 10/05/2021
Date Signed: 10/05/2021 03:16:01 PM

Document Has Been Signed on 10/05/2021 03:16 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:RAINBOW AFTER-SCHOOL CARE & PRE-K PROGRAMFACILITY NUMBER:
304270963
ADMINISTRATOR:MC INTOSH, INEZFACILITY TYPE:
850
ADDRESS:4343 PICKWICK CIRCLETELEPHONE:
(714) 846-8386
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92649
CAPACITY: 77TOTAL ENROLLED CHILDREN: 0CENSUS: 15DATE:
10/05/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Owner/ Adminsitrator Ms.Armstrong TayTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced Case Management Licensee initiated inspection for a change in capacity. Licensee is requesting a change to the current Preschool age capacity from 77 to 24 children (3-5 years) Licensee is decreasing the capacity by removing Room # 37 and shall continue to use only room # 38 for Preschool age children.

LPA met with Facility Administrator Ms. Armstrong Tay, who gave a tour of the preschool room # 38.

All areas identified on the Facility Sketch were inspected. Furniture and equipment were inspected for age appropriateness and good repair in the Preschool age room. First Aid supplies were inventoried. Playground is completely enclosed by a fence. Outdoor activity area is supplied with age and size appropriate equipment including a climbing structure. An adequate amount of cushioning material is (wooden chips) in place under the equipment. Drinking water is available through personal water bottles and Brita filtered water . A review of medication policy, including administering, labeling, storage, and records were made, disaster drills, posting requirements, children records, mandated child abuse and injury/death reporting, and criminal records clearances/exemption transfer requests.



Facility shall continue to use the School play yards and bathrooms designated for the program and there is Waiver on file.

Based on today's inspection facility has enough space for the requested capacity of 24 children in the assigned room # 38 only.

Indoor measurement: Room # 38 : 39 x 23= 897 sq feet divided by 35= 25.62 (26 children)

Administrator Ms. Armstrong is current on the required CPR training (11/21)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2021
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RAINBOW AFTER-SCHOOL CARE & PRE-K PROGRAM
FACILITY NUMBER: 304270963
VISIT DATE: 10/05/2021
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Based on the indoor measurements, Facility shall be granted an approval for 24 Preschool age children age (3-5 years old) in Room # 38.

License shall be granted after the final approval by the management.

Report was read to the Facility Administrator and appeal rights were provided.

Notice of site visit posted.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC809 (FAS) - (06/04)
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