304370363-8-15-2023-06-CC-MMAK-CUQQRT-20230815122424

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370363
Report Date: 08/15/2023
Date Signed: 08/15/2023 12:24:29 PM

Document Has Been Signed on 08/15/2023 12:24 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	HBCSD-PRESCHOOL ACADEMY		FACILITY NUMBER:	304370363
ADMINISTRATOR:	BECK, CAROLYN		FACILITY TYPE:	850
ADDRESS:	9291 BANNING		TELEPHONE:	(714) 962-2451
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY: 52	TOTAL ENROLLED CHILDREN: 52	CENSUS: 0	DATE:	08/15/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jason Reyes		TIME COMPLETED:	10:30 AM

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	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of the facility moving from room 5 to room 32 without changing their capacity. Currently the facility has been licensed for 52 preschool children ages 3 to 5 years old in rooms 5, and 6 Monday to Friday from 9:00 am to 1:00pm. LPA met with the applicant/ Director of Early Childhood Education, Jason Reyes who gave LPA a tour of the facility. The facility is located on the ground of Eader Elementary school. There were no children present due to Summer Break. The school starts 9/11/2023. The facility is running Title 5 program and operating from 9am -1pm. During this inspection applicant informed LPA that they are not interested to increase their capacity by adding room 32. He stated they decided to decrease their capacity at this site by keeping room # 6 only. A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. (The staff are employees of Huntington Beach City Unified School District). The facility provides morning snack and parents provide lunch to their children. Children do not nap in this program. The children are dropped off and are singed in and out at the entrance manually. The facility has met all the posting requirements. All areas identified on the Facility Sketch were inspected. If children become ill during the day, they will rest in the isolation area located, in the nurse’s office, next to the school office, away from the other children, and use the adult restroom. Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370363
	VISIT DATE: 08/15/2023

NARRATIVE

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Following was observed in room # 6:
Age appropriate furniture and activities including Educational, arts & crafts items.
Room is well ventilated with proper lighting and shade.
There is a working Smoke detector. Carbon Monoxide detector was not observed.

Outdoor Activity Space: Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment with adequate of cushioning materials under the climbing structure such as, slides. Shade is provided by building structure and anwnigns. There is a waiver on file to share the playground with Kindergarten children and children with Special Education Program.
Fire clearance approval has been received approving the requested capacity of 124 children.

The measurement of all the room is as below:
The indoor activity space measurement for the current requested capacity is as follows:
Room 6 is: 899 square feet divided by 35 square feet = 25.68 (26 children)
Total of sinks: 3 X 15 = 45 children
Total of toilets: 3 X 15 = 45 children
There is one sink in the classroom. There are 3 toliets and 2 sinks in a bathroom that will be shared with children with Special Education Program on this site.
A waiver will be requested to share the restroom.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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.

LPA reviewed with applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Continued on page 3

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: HBCSD-PRESCHOOL ACADEMY	FACILITY NUMBER: 304370363
	VISIT DATE: 08/15/2023

NARRATIVE

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The site supervisor of this site is Carolyn Beck. A Site Supervisor packet was submitted to LPA during this inspection.

Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant Jason Reyes.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Based on today’s measurements, the sinks and toilets availability, the request of the facility for decreasing the capacity to 26 children in room # 6 will be final reviewed and discussed with management in the Regional Office and after receiving the following corrections. The facility will be notified if any additional information is required.

1- LIC 200A for requesting to decrease their capacity to 26 children.
2- LIC 999 reflecting room # 6
3- 25.00 check payable to DSS to decrease the capacity
4- Carbon Monoxide for room # 6
5- Installing alarm device on the exit door on the playground leading to parking lot which easily opens with a push bar or any other solution to make the exit gate not easy access to the parking lot.
6- Waiver request to share the restroom with another program. For waiver, please send waiver request letter, LIC 500, sketch of the restroom with a photo of posting signs to state "State Preschool
End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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