304371434-9-11-2020-06-CC-KDEI-BTCQMY-20200911121819

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371434
Report Date: 09/11/2020
Date Signed: 09/11/2020 12:18:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	E-PLEX PRESCHOOL		FACILITY NUMBER:	304371434
ADMINISTRATOR:	LEE, SUNHWA		FACILITY TYPE:	850
ADDRESS:	6940 BEACH BLVD. UNIT D-212		TELEPHONE:	(714) 933-9400
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90621
CAPACITY:	105	CENSUS: 0	DATE:	09/11/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Ms. Lee Sunhwa. Ms. Hae Yoon Jung and Director Ms. Byun Haesook		TIME COMPLETED:	12:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Ketki Desai conducted an on site pre licensing inspection at this proposed child care center. LPA’s met with Facility Administrator Ms. Lee Sunhwa, Ms. Hea Yoon Jung and Program Director Ms. Byun Haesook and toured the new center. The applicant has requested to provide care and supervision for children 2 to 5 years of age, Monday through Friday, 7.30 am. to 6.00 PM, in the four assigned rooms ( Monkey/ Koala/ Lion and Tiger room) . 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 facility is located on the second level of the commercial mall, it has a main entrance door next to the elevators, per Facility Administrator the main door shall remain closed and locked, parents shall access the door by the installed Ring bell. Facility Reception area is located in front of the entrance door to guide the parents upon entering the facility. There is sign in table on the right side upon entrance where parents shall sign in manually and the staff shall guide the children to their assigned classrooms. Upon entering the Director‘s office is on the left hand side and it will serve as the isolation area for ill children temporarily until parents arrive. The staff/adult restroom will be used as the isolation restroom for ill children and is conveniently located to the isolation area. Incidental Medication services shall be provided by the facility, required medications will be stored in the Director’s office in a locked cabinet. Medication administration forms were reviewed. First Aid supplies were inspected and are stored in the Director’s office. EMSA approved Pediatric CPR & First Aid are current for the director and expires on ( August 2021) .Applicant and the Program Director have completed the 8-hour Preventative Health Practices and Nutrition and Lead Course. The facility is a new construction completed in 2020. Page-1

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: E-PLEX PRESCHOOL	FACILITY NUMBER: 304371434
	VISIT DATE: 09/11/2020

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

The following were inspected in the indoor activity space:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside by filtered water dispenser (Water pitchers in each class and water fountain in the out door area.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements
· Cubbies available for storage of individual child’s personal belongings and/or bedding in each classroom
· Napping equipment shall be stored in individual cubbies when not in use and cots shall be used. Linens are to be provided by the parents.
Center shall be catering the daily snacks and lunch for the children, there is kitchen area. Snacks shall be prepared in the Kitchen area and would be taken to each classroom. Storage area was equipped with refrigerator and cabinets. Dry snacks shall be stored in air tight containers. The kitchen area shall be locked inaccessible to children. Evaluator reviewed Title 22 Sections 101227 and 101327 with applicant and that the licensee is ultimately responsible to provide adequate, nourishing food. If food is brought from home the containers shall be labelled and stored appropriately .

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
(page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC809 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: E-PLEX PRESCHOOL	FACILITY NUMBER: 304371434
	VISIT DATE: 09/11/2020

NARRATIVE

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· Menus
· Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies
· Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)

The indoor activity space was measured and is as follows: Preschool rooms
Preschool Monkey (Big area) 33.08 x 20.92= 692.03
Preschool Monkey (Small area) 19.08 x 7.83 = 149.39
Preschool Koala (Right area) 25.83 x 7.08 = 182.88
Preschool Koala (Middle area) 30.67 x 19.58 = 600.52
Preschool Koala (Left area)23.83 x 9.92 = 236.39
Preschool Lion (small area)22.5 x 23.33 = 524.93
Preschool Lion (Big area) 29 x 18.25=529. 25
Preschool Tiger room 33.75 x 22.92 = 773.55

Total square feet 3688.94 divided by 35 = 105.40

Total children toilets and sinks:
Toilets: 10 X 15 = 150 children ( 7 stalls and 6 urinals)
Sinks: 9 X 15 = 135 children ( includes 3 sinks outdoor yard)

LPA discussed with the applicant/facility representative that all employees must have criminal record clearances associated to the facility prior to their presence in the facility, staff to child ratio requirements, direct visual supervision requirements, emergency/disaster drills, children records, mandated reporter training, and staff immunization requirements against measles, pertussis, and influenza. Applicant/facility representative was advised the children's bedding must be stored individually and may not touch another children's bedding.

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SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: E-PLEX PRESCHOOL	FACILITY NUMBER: 304371434
	VISIT DATE: 09/11/2020

NARRATIVE

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Total outdoor activity space : The facility has an open indoor yard, it is completed fenced from all the sides, with artificial grass flooring, there is an installed mist following in the play yard. The roof is covered which serves as a shade including there are two pill up canopies providing additional shade area. The yard has three sinks and two water fountains installed, the children shall use the restroom in the Monkey room. Age appropriate outdoor toys were observed. There are no climbing structures at this time.

Outdoor measurements were as follows : 41.50 x 55.33 = 2296.20 divided by 75= 30.62
A Waiver request has been submitted for a staggered schedule in-between the four preschool classrooms.

The applicant was given a pamphlet on Lead Exposure and was discussed with provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf

Applicant/facility representative was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to down load forms, Title 22 regulations, and training's on-line at www.ccld.ca.gov. The applicant/facility representative was also informed to visit the website for Quarterly Updates. The applicant was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. or at www.ccld.ca.gov

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The applicant/facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness

The facility was in compliance with Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has sufficient activity space to support the capacity of 105 ( Preschool children) . A license will be issued for the capacity requested after a final review. The applicant will be notified if any additional information is required.

Orange County Fire Authority has granted the requested capacity for 105 preschool children age 2-5 years old. (Page -4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: E-PLEX PRESCHOOL	FACILITY NUMBER: 304371434
	VISIT DATE: 09/11/2020

NARRATIVE

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Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if A violations are cited then the Licensing Report (LIC 809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed, and the report shall posted and copies provided to the parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

An exit interview was completed.

The report was reviewed and discussed. Appeal Rights were discussed. The applicant was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC809 (FAS) - (06/04)

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