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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
304371193
Report Date:
10/22/2024
Date Signed:
10/23/2024 09:31:48 AM
Document Has Been Signed on
10/23/2024 09:31 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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
ADMINISTRATOR/
DIRECTOR:
JANKI SHAH
FACILITY TYPE:
850
ADDRESS:
827 W. STEVENS AVE
TELEPHONE:
(657) 231-6318
CITY:
SANTA ANA
STATE:
CA
ZIP CODE:
92707
CAPACITY:
54
TOTAL ENROLLED CHILDREN:
19
CENSUS:
12
DATE:
10/22/2024
TYPE OF VISIT:
Annual/Random
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:
Joying Chen
TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 10/22/2024, Licensing Program Analyst (LPA), Christine Jung, conducted an onsite inspection for the purpose of an Annual Inspection. Upon arrival at 9:00AM, LPA was led on a tour by facility representative, Jo Ying “Zoe” Chen. The overall census observed was four (4) preschool staff and 12 preschool children. Facility hours are 7:30AM – 6:00PM, Monday through Friday.
The Facility Personnel Report Summary reviewed 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. Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
During the inspection, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be accessible to children; see LIC 809D for deficiency. Facility representative put all cleaning compounds and disinfectants in the office where it is inaccessible to children in care. Poisons/hazardous items are kept on the premises and were not in a locked area; see LIC 809D for deficiency. Food is prepared on site; AM and PM snacks are provided. Food prep areas were clean and sanitary; food was properly stored. Menus were posted where they could be reviewed by authorized representatives. Floors, children’s equipment, and furniture were clean, observed to be in good repair, and free of sharp edges. Storage containers for solid waste, including moveable bins, did not have tight fitting covers that were kept on and in good repair; see LIC 9102 for TV. There was drinking water available, both indoors and outdoors, to children by refillable bottles labeled with the children’s names. The facility purchases water from Sparkletts for drinking.
(Go to Page 2)
SUPERVISORS NAME
:
Martha Malane
LICENSING EVALUATOR NAME
:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that disinfectants and cleaning solutions were left in areas accessible to children in care, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/22/2024
Plan of Correction
1
2
3
4
Facility representative put away all disinfectants and cleaning solutions into an inaccessible area.
Type B
Section Cited
CCR
101238(g)(1)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. (1) Storage areas for poisons shall be locked.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that, poisons were left in areas accessible to children in care, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/22/2024
Plan of Correction
1
2
3
4
Facility representative put away all poisons into an inaccessible area.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
2
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that, there were items which were broken or in disrepair in the play yard (children's tricycle, unidentifiable broken tile, broken back gate, plastic toy gate), which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/05/2024
Plan of Correction
1
2
3
4
Facility representative stated they will fix all broken items and send LPA picture proof by due date.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
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 in that, 2 out 5 staff did not complete mandated reporter training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/05/2024
Plan of Correction
1
2
3
4
Facility representative stated they submit proof of trainings to LPA via email by due date.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
3
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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 in that, 4 out 5 staff did not have at least one of the following (influenza, pertussis, measles), which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/12/2024
Plan of Correction
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2
3
4
Facility representative stated they will submit proof of completed immunizations for all staff to LPA by due date. LPA provided detailed list of needed immunizations to facility representative.
Type B
Section Cited
CCR
101215.1(f)
Child Care Center Director Qualifications and Duties
(f) When the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher as specified in Section 101216.1(c) to act as substitute. This substitute child care center director shall be aware of center operations, including total enrollment; shall be trained in program operation; and shall be designated as an authorized person to correct operational deficiencies that constitute immediate threats to children's health and safety.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in that, there was not a qualified substitute in place of the director present at the facility, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/31/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit documentation for director or qualified substitute to LPA by due date.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
4
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.
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 in that there was no director or substitute director with 16 hours of health and safety training completed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/31/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit 16 hours of health and safety training for director or qualified substitute to LPA by due date.
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.
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 in that, none of the staff members present had current CPR & First Aid certificate for review, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/05/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit proof of CPR & First aid training to LPA by due date.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
5
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.
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 in that, 2 out 5 staff files did not have health screening for review, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/12/2024
Plan of Correction
1
2
3
4
Faciity representative stated they will submit health screening for staff to LPA by due date. Names of staff were given to facility representative.
Type B
Section Cited
CCR
101216.1(b)(2)
Teacher Qualifications and Duties
(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below: (2) A teacher shall meet the requirements of Health and Safety Code Section 1597.055.
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 in that, 5 out 5 staff did not meet all the requirements of Health and Safety Code Section 1597.055 prior to employment, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/12/2024
Plan of Correction
1
2
3
4
Faciity representative stated they will provide LPA a written plan by the due date detailing their plan to ensure that all staff fulfill requirements of Health and Safety Code section 1597.055 prior to employment.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
6
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.
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 in that, 4 out of 5 staff did not meet education requirement to be a qualified teacher, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/29/2024
Plan of Correction
1
2
3
4
Facility representative stated they will provide proof of enrollment for staff who are missing required education units.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(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. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.
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 in that, 2 out 4 children files did not have physician's report in their files, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/12/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit physician's report for children to LPA by due date. LPA provided facility representative list of children missing physician's reports.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
7
of
26
Document Has Been Signed on
10/23/2024 09:31 AM
- It Cannot Be Edited
Created By:
Soo Jin Jung
On
10/22/2024
at
02:27 PM
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/22/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101221(a)
Child's Records
(a) The licensee shall ensure that a separate, complete and current record for each child is maintained in the child care center.
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 in that, 5 out of 5 children's files were not complete, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/05/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit complete children's records to LPA by due date.
Type B
Section Cited
CCR
101212
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in that, facility did not report to the department within 10 days of a change of child care center director or designee, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
10/29/2024
Plan of Correction
1
2
3
4
Facility representative stated they will submit a plan to LPA by due date ensuring that the facility will submit all changes to the department in a timely manner. Facility representative stated they will submit update Designation of Facility Responsibility LIC 308 to LPA by due date.
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
LICENSING EVALUATOR NAME:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
8
of
26
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
VISIT DATE:
10/22/2024
NARRATIVE
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(Page 2)
The children's restrooms were clean and sanitary. Children nap on cots, bedding was stored individually. The facility conducted an emergency drill in October 2024. Facility did not complete emergency drill log; see LIC 9102 for TA. The facility had a working carbon monoxide detector. Facility did not meet all posting requirements; see LIC 9102 for TV.
Per regulation, when the child care center director is absent from the center, arrangements shall be made for a fully qualified teacher as specified in Section 101216.1(c) to act as substitute. Facility did not have a fully qualified teacher to act as substitute and did not report within 10 days of a change of child care center director or designee(s); see LIC 809D for deficiency.
Five (5) staff files were reviewed. 5 out 5 staff files reviewed were incomplete; see LIC 809D for deficiency cited.
Four (4) children files were reviewed. 4 out of 4 children reviewed were incomplete; see LIC 809D for deficiency. Sign in/out procedure was reviewed for compliance. The facility uses a digital app called Brightwheel for sign in and out procedure.
The outdoor activity space was inspected for compliance and was enclosed by a fence. The surface of the outdoor activity space was well maintained and free of hazards. There were items which were broken or in disrepair in the play yard; see LIC 809D for deficiency. The cushioning material made of commercially produced rubber around the climbing equipment, slides, and other similar equipment was sufficient to absorb falls. Facility representative stated there are no bodies of water present at the facility.
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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Facility completed lead testing in 09/2022.
(Go to Page 3)
SUPERVISORS NAME
:
Martha Malane
LICENSING EVALUATOR NAME
:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
Page:
25
of
26
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:
NI HAO PRESCHOOL-COSTA MESA
FACILITY NUMBER:
304371193
VISIT DATE:
10/22/2024
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LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. At this time, the facility is not providing care for children with medical needs. 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
The facility representative was informed that Licensing Quarterly Updates are available at
www.ccld.ca.gov
Facility representative 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
Based on LPAs observations, record reviews, and interviews, the following violations were observed and are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1. See LIC 809D and LIC 9102 for violations cited, technical violations, and technical assistance provided: 14 Type B, 14 TV, 2 TA.
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process
.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the facility representative, Jo Ying “Zoe” Chen.
SUPERVISORS NAME
:
Martha Malane
LICENSING EVALUATOR NAME
:
Soo Jin Jung
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/22/2024
LIC809
(FAS) - (06/04)
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