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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370933
Report Date: 05/31/2023
Date Signed: 05/31/2023 12:11:20 PM

Document Has Been Signed on 05/31/2023 12:11 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:RAINBOW KIDS ACADEMYFACILITY NUMBER:
304370933
ADMINISTRATOR:CYRANO ANTONYFACILITY TYPE:
850
ADDRESS:12914 HAZEL AVENUETELEPHONE:
(714) 638-8210
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 4DATE:
05/31/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Director Evelyn RodriguezTIME COMPLETED:
09:30 AM
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On 05/31/2023, Licensing Program Analyst (LPA) Romy Castanon and LPA Patricia Rivas conducted a Case Management due to deficiencies observed during today's inspection. LPA Rivas arrived at 7:30am and was greeted by one staff member and one child in Preschool Room #3. LPA Castanon and Director Evelyn Rodriguez arrived at 7:40am. Throughout the morning, three more children arrived for a total of four.

During LPA’s time in Preschool Room 3, LPA’s observed a large area rug with mild stains and four large pieces of blue duct tape directly on the rug. There is an orange door that leads to the storage room. LPA’s observed two large paint chips that were peeled about 6 inches in diameter on the door. There are two large floor-to-ceiling posts near the entrance of the room. There are wood moldings around only one post. There is a cement base that is completely exposed on the second post.

During LPA’s children’s file review, 3 out of 6 children files did not have a physician’s report. 2 out of 6 children did not have a copy of LIC9224 regarding a licensing office conference on 10/17/2022.

Based on LPA’s observation, the facility is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101238(a) Buildings and Grounds, as well as, Health & Safety Code 1596.8595 reports to be provided to parents or guardian of each child receiving services.

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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Evelyn Rodriguez.

(End of Report)

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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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Document Has Been Signed on 05/31/2023 12:11 PM - It Cannot Be Edited


Created By: Romelia M Castanon On 05/31/2023 at 09:58 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RAINBOW KIDS ACADEMY
FACILITY NUMBER: 304370933

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/07/2023
Section Cited
CCR
101238(a)

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101238(a) Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:
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Director will email photos of clean rug with no tape, cement base covered and no paint peels on storage room door by POC date.
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LPA Castanon and LPA Rivas observed a large area rug with mild stains and duct tape, storage room door with two large paint peels and a wooden post with an exposed cement base. This poses a potential risk to the health, safety or personal rights of children in care.
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Type B
06/30/2023
Section Cited
CCR101220(a)

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101220(a)Children's Medical Assessment (a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child...center can provide necessary health-related services to the child. This requirentment was not met as evidenced by:
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Director will notify parents to obtain children's physician reports. Director will email copies of reports received to LPA by POC date. Child #1 will no longer be attending facility prior to POC date.
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During LPA Rivas' record review, 3 out of 6 children's files were missing a complete physician's report. This poses a potential risk to the health, safety or personal rights to the children in care.
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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:Rina Lopez
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/31/2023 12:11 PM - It Cannot Be Edited


Created By: Romelia M Castanon On 05/31/2023 at 10:52 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RAINBOW KIDS ACADEMY
FACILITY NUMBER: 304370933

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/07/2023
Section Cited
HSC
1596.8595(d)(1)

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(d)(1)... child receiving services in the facility copies of any licensing document pertaining to a conference conducted by a local licensing agency management representative with the licensee in which issues of noncompliance are discussed. This requirement was not met as evidenced by:
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Director will provide copy of LIC9224 to parents to sign. Director will email LPA copies of signed LIC9224 by POC date. Director will keep copies of LIC9224 in all children's files.
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During LPA's children's record review, 2 out 6 children files did not have a signed copy of LIC9224. This poses a potential risk to the health, safety or personal rights to the children in care.
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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:Rina Lopez
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2023


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