304270999-4-17-2024-06-CC-AFCN-D4EUPW-20240417154612

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270999
Report Date: 04/17/2024
Date Signed: 04/17/2024 03:46:20 PM

Document Has Been Signed on 04/17/2024 03:46 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:	TOPAZ HEAD START		FACILITY NUMBER:	304270999
ADMINISTRATOR:	AMY BIGELOW		FACILITY TYPE:	830
ADDRESS:	1600 SAPPHIRE ROAD		TELEPHONE:	(714) 854-1534
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92831
CAPACITY:	16	CENSUS: 9	DATE:	04/17/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Site Supervisor Carmen Mora		TIME COMPLETED:	04:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 04/17/24, Licensing Program Analyst (LPA), Anna Chan conducted an unannounced onsite inspection for the purpose of an Annual Random Visit. LPA met with Site Supervisor Carmen Mora and 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 9 infant and 5 staff. Children were napping when LPA arrived around 1:10pm. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:30a.m.- 5:30p.m., Monday through Friday. 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. All staff is fingerprint associated through a master file under Matt Kline Headstart (300603968) 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. The OC Headstart Placentia Kitchen delivers food at the facility. Menus are posted where it can be seen by parents in the classrooms. Parents are also provided with a copy of menu every month through Learning Genie App. Allergy list of children are also placed in a cupboard in each classroom. Water is provided by a filtered water and Brita water dispenser and sippy cups with children’s name on it. Infants 12 months and below nap on cribs and infants 12 months and above nap on cots. Beddings are stored individually. Sheets and blankets are washed by the facility daily. The facility conducted an emergency drill on 03/14/24. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility. Page 1

SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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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Document Has Been Signed on 04/17/2024 03:46 PM - It Cannot Be Edited

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: TOPAZ HEAD START	FACILITY NUMBER: 304270999
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above lead testing was done after January 1, 2023. Lead test dated March 25,2023, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/17/2024
	Plan of Correction
1 2 3 4	The facility passed lead test with no exceedance on 3/25/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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: TOPAZ HEAD START	FACILITY NUMBER: 304270999
	VISIT DATE: 04/17/2024

NARRATIVE

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The outdoor activity space was inspected for compliance. The infant 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 playground has a rubberized surfacing around the climbing structure such as slide and other climbing equipment which appears to be enough to absorb falls. Drinking water in the outdoor activity space is provided by filtered water and sippy cups with the children’s name on it. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water at the premises.

5 Staff files were reviewed for 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 11/2025.

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

CCC COMPLETED TESTING AND HAS NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

The facility has done Lead Test on March 25, 2023 with no exceedance

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SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: TOPAZ HEAD START	FACILITY NUMBER: 304270999
	VISIT DATE: 04/17/2024

NARRATIVE

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Currently, there are medications in 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 Site Supervisor 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, a Type B deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. HSC 1597.16(a)(1). Please see LIC 809D for deficiencies.

An Inspection and exit interview were completed with Site Supervisor Carmen Mora. The report was reviewed and discussed. 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.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive 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.

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SUPERVISOR'S NAME: Martha Malane	TELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Anna Francesca Chan	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC809 (FAS) - (06/04)

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