304371252-7-11-2023-06-CC-ASIA-CTN2MC-20230711173054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371252
Report Date: 07/11/2023
Date Signed: 07/11/2023 05:31:00 PM

Document Has Been Signed on 07/11/2023 05:31 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:	APPLE TREE PRESCHOOL & KINDERGARTEN		FACILITY NUMBER:	304371252
ADMINISTRATOR:	PERANCULLO, MARBEN		FACILITY TYPE:	850
ADDRESS:	2211 WEST WOODLEY AVENUE		TELEPHONE:	(714) 772-1005
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	60	CENSUS: 52	DATE:	07/11/2023
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME BEGAN:	02:24 PM
MET WITH:	Ishara Silva		TIME COMPLETED:	05:40 PM

NARRATIVE

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On 7/11/23 at 2:30 pm, Licensing Program Analyst (LPA) A. Silva conducted an unannounced Case Management – Legal/Non-Compliance inspection assisted by Director Ishara Silva, Area Director Margarita Calero, and Licensee Harshi Antony. Census at the time of the visit was 52 children (19 in classroom A, 11 in classroom B, 8 in classroom C, 7 in classroom D, and 7 in classroom E). The children in classroom C were school-age clients. The rest of the children were preschool-age clients. The facility was operating within its licensed capacity and within compliance of staff-to-child ratios. An on-site Facility Personnel Report Summary review showed that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions, except for Teresa Solis (See 809D).

The licensee was informed that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption prior to the initial presence in a licensed child care facility. Violation of this requirement will result in a citation of a deficiency and civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days. Subsequent violations within a twelve (12) month period will result in a civil penalty of one hundred dollars ($100) per violation per day for a maximum of thirty (30) days in accordance with Section 1596.871 of the Health and Safety Code.

Upon arrival, the LPA toured the facility and took a census of individual classrooms. The LPA interviewed the teachers about their daily activity plan and strategies to stay within capacity. The teachers stated that they have some children come in part-time only. When the classroom is to its full capacity, older children are temporarily sent to an older age range classroom to stay within ratio. The director stated that when there are more children than ratios permit, the facility rotates the older children to an older age range classroom to stay within ratio. According to the director, parents are aware of the rotations and they have verbally agreed to the rotation strategy.

continue on 809 page 2

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo Silva	TELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

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: APPLE TREE PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304371252
	VISIT DATE: 07/11/2023

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809 Page 2

The LPA reviewed the teacher-child ratio and capacity regulations with Director Ishara Silva, Area Director Margarita Calero, and Licensee Harshi Antony. The Director demonstrated knowledge about ratios and about the center’s capacity when asked about the regulations.

Based on an LPA’s records review and interviews conducted with the teachers, director and the licensee, the facility is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101170(e)(1) Criminal Background Clearance for one (1) staff who did not obtain a California clearance or a criminal record exemption as required by the Department.

LPA A. Silva informed Director Ishara and Licensee Harshi that this licensing report documents 1 “Type A” citation(s). Type A citation(s) must be posted for 30 consecutive days during the hours that children are in care as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. LPA further informed the licensee that:

A copy of this licensing report must be provided to parents or guardians of all clients currently enrolled by the next business day or by the next day the children are in care.
A copy of this report must be provided to the parents or guardians of all newly enrolled clients for 12 months from the date of this report.
A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) form, or another written equivalent statement, must be placed in the child's file for verification of receipt of the report.

The LPA conducted an exit interview and reviewed the report with the licensee and the directors. The “Notice of Site Visit” was posted and the licensee is aware that it shall remain posted for 30 days. The Appeal Rights were explained. The licensee received a copy of the Appeal Rights (LIC 9058 01/16), 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. First-level appeals should be sent to the Regional Manager to the address listed above.

End of report.

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo Silva	TELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 07/11/2023 05:31 PM - It Cannot Be Edited

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: APPLE TREE PRESCHOOL & KINDERGARTEN	FACILITY NUMBER: 304371252
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type A 07/12/2023 Section Cited CCR 10170(e)(1)	1 2 3 4 5 6 7	101170(e)(1) All individuals subject to a criminal record review shall... (1) Obtain clearance or a criminal record exemption as required ... The licensee did not meet this requirement as evidenced by:	1 2 3 4 5 6 7	The licensee asked Teresa Solis to leave the premises while the LPA was present. The licensee stated she would send Ms. Solis to get a live scan. The licensee stated Ms. Solis will return when cleared.
	8 9 10 11 12 13 14	Based on observation, interviews, and records review, the licensee did not comply with the above regulation in 1 of 6 staff present, which poses a health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo Silva	TELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

LIC809 (FAS) - (06/04)

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