304370402-6-15-2026-06-CC-CSUN-DV3P65-20260615110145

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370402
Report Date: 06/15/2026
Date Signed: 06/15/2026 11:01:58 AM

Document Has Been Signed on 06/15/2026 11:01 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	DR. JONAS SALK SCHOOL READINESS ROOM		FACILITY NUMBER:	304370402
ADMINISTRATOR/ DIRECTOR:	GONZALEZ, MARIA ROSALINDA		FACILITY TYPE:	850
ADDRESS:	1411 S. GILBERT		TELEPHONE:	(714) 527-2154
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	06/15/2026
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:40 AM
MET WITH:	Director, Stephanie Dang		TIME VISIT/ INSPECTION COMPLETED:	11:10 AM

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Licensing Program Analysts (LPAs) Cynthia Sun and Karen Navar conducted a case management inspection of the facility for the purpose of an increase capacity and room addition. Upon arrival LPAs met with Director, Stephanie Dang who guided LPAs for a walk-through of the facility. LPAs inspected the indoor and outdoor space and director stated there are no staff or children at the facility.

The facility is currently licensed for 24 children in room 55 and is requesting to add 24 children to room K1 with an overall increase capacity of 48 children. An approved Fire clearance was received 6/2/26 with an approved capacity for 24 children. Director stated facility is requesting for both classrooms 55 and K1 to be licensed with an overall capacity of 48 children and would like the Fire Clearance to be re-sent to match the requested capacity of 48 children. Facility hours Mare onday to Friday from 8:00 AM to 3:00 PM. Facility runs Title 5 program. Room 55 hours are morning session from 8am-11am and the afternoon session from 12pm-3pm. Room K1 hours will be from 8:00 AM to 3:00 PM.

Facility is a part of Magnolia School District and indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Room K1 measured a total of 1099.1 square feet which is sufficient for the requested capacity of 24 children. Room K1 has 3 sinks and 2 toilets for children to use. Room 55 measured a total of 856.51 square feet which is sufficient for the requested capacity of 24 children. There is 1 sink and 1 toilet in room 55 for children to use.

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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Cynthia Sun
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: DR. JONAS SALK SCHOOL READINESS ROOM	FACILITY NUMBER: 304370402
	VISIT DATE: 06/15/2026

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California Code of Regulations, Title 22, Division 12, Section 101238.2, Section 101438.2, and Section 101538.2 require 75 square feet per child of outdoor activity space. Facility will be sharing the playground with Elementary School children. Playground is completely enclosed by at least 4 feet high fence. Outdoor space is large enough to accommodate the requested capacity. Playground includes: pour and play, black top, grass area, and climbing structures, etc. Outdoor activity is supplied with age and size appropriate equipment. An adequate amount of cushioning material (pour and play, black top, and grass) is in place under and around all climbing equipment. Shade is provided by surrounding trees and the climbing structure canopy’s. There is drinking water available by drinking fountains and water station located on the playground. Applicant is requesting a waiver to share playground with the elementary, TK and kindergarten children.

The facility will submit a waiver and application LIC200A for share the outdoor activity space and a waiver to share the restroom with kindergarten children from this elementary school.

Facility was not in compliance with Title 22 Regulations at the time of inspection. The Director is required to submit the following corrections to the licensing office by the due date of 6/19/26.

1. Fire Clearance was approved for a capacity of 24 children.

2. Approved Playground Waiver reflects Room 55 only.

3. LIC 200A reflects capacity 24 children.

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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Cynthia Sun
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

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: DR. JONAS SALK SCHOOL READINESS ROOM	FACILITY NUMBER: 304370402
	VISIT DATE: 06/15/2026

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A license will be issued once all requirements are met.

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 plat form.

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 Director, Stephanie Dang.

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End of report

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Cynthia Sun
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

LIC809 (FAS) - (06/04)

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