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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370401
Report Date: 02/21/2023
Date Signed: 02/21/2023 10:57:05 AM

Document Has Been Signed on 02/21/2023 10:57 AM - 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:JULIETTE LOW SCHOOL READINESS ROOMFACILITY NUMBER:
304370401
ADMINISTRATOR:PALAVICINI, ROSAFACILITY TYPE:
850
ADDRESS:215 NORTH VENTURATELEPHONE:
(714) 527-2154
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 48TOTAL ENROLLED CHILDREN: 22CENSUS: 18DATE:
02/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Site SupervisorTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of decreasing capacity from 48 preschool children to 24 preschool children by taking off room # 2 off of the license. LPA met with site supervisor, Rosa Palavicini. LPA also met with Stephanie Dang, Early Learning Instructional Practices Coach with Magnolia School District. Census was taken. Currently the facility is licensed for 48 children in rooms # 1 and 2. The licensee has requested to provide care and supervision for 24 preschool children in room # 1 for ages 3 to 5 years old, Monday through Friday, 8:00 a.m. to 4:00 p.m. Today the total census were 18 preschool children with 5 staff including the Site Supervisor. .
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 Magnolia School District)
The State Preschool is a Title 5 Program that offers two morning and afternoon sessions. Morning hours are from 8:am to 11:00 am and afternoon session is from 12:00 noon to 3:00 pm. The facility provides morning snack and afternoon lunch to children. Children do not nap in this program. The children are dropped off and are singed in and out at the entrance.. The facility has met all the posting requirements.

The indoor activity space measurement for the current requested capacity is as follows:
Room # 1: 832.20 square feet.
Total indoor space is 832.50 square feet divided by 35 = 23.78 (24 children)
Outdoor activity space is the School Playground that is shared with Kindergarten and Transitional Kindergarten from this Elementary School. There is a waiver on file. The playground is large enough to accommodate 24 preschool children.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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: JULIETTE LOW SCHOOL READINESS ROOM
FACILITY NUMBER: 304370401
VISIT DATE: 02/21/2023
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There is one sink in Room # 1 for children's usage. Additionally the preschool has a waiver in place to use additional restroom that is close to the classroom. There are 5 toilets and 5 sinks in the girl's restroom for preschool children's use.
The classroom is equipped with carbon monoxide detector. The restrooms and playground were inspected. There were adequate cushioning materials under and around the climbing structure on the playground
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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)/ (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

Orange county Fire authority has approved the requested capacity of 24 preschool children and is on file.
Based on today’s measurements, the sinks and toilets availability, the request of the facility for decreasing the capacity to 24 children will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required.
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 platform. 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. Exit interview conducted and report was reviewed with the Site Supervisor, Rosa Palavicini.

The following are needed to be sent to our office

1- LIC 215 for the applicant and board resolution letter to authorizes the person as applicant on file.

3- Association of applicant on file to all the School Sites.

4- Verification of TB clearance for applicant on file.

5- LIC 309

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
LIC809 (FAS) - (06/04)
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