304371456-12-18-2020-06-CC-KDEI-BWEU3K-20201218141341

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371456
Report Date: 12/18/2020
Date Signed: 12/18/2020 02:14:10 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:	LITTLE BIG PRESCHOOL		FACILITY NUMBER:	304371456
ADMINISTRATOR:	DUNN, DEREK PASTOR		FACILITY TYPE:	850
ADDRESS:	27111 ALISO CREEK ROAD # 100		TELEPHONE:	(949) 265-0440
CITY:	ALISO VIEJO	STATE: CA	ZIP CODE:	92656
CAPACITY:	15	CENSUS: 0	DATE:	12/18/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Administrator Dunn, Derek Pastor and Director Ms. Holifield.		TIME COMPLETED:	02:30 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 the proposed childcare center. LPA met with Administrator, Pastor Derek Dunn and Director Ms. Sarah Holifield, who gave a tour of the new Child Care Center. The applicant has requested to provide care and supervision for 15 Pre-school age children 2 to 6 years of age, Monday through Friday, 8.30 a.m. to 6.00 p.m. in the assigned one classroom with Indoor activity area. The center is inside the Church complex within a Business park, surrounded by offices. 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 children shall have access through the side entrance of the facility, located on the side parking area surrounding the complex, there is ample open parking space for parents for easy drop off and pick up. Upon entering the facility, due to current pandemic situation, children are received at the entrance by the staff who are present at the reception area, temperatures are checked, hands are sanitized before they are taken to their classroom. Parents sign them in at the entrance manually, currently outside visitors are not allowed in the facility. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020

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: LITTLE BIG PRESCHOOL	FACILITY NUMBER: 304371456
	VISIT DATE: 12/18/2020

NARRATIVE

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Medication will be stored in the locked cabinet in the cabinet, and shall be administered by the Director or the Facility in charge, emergency First Aid kit is stored in the classroom in assigned cabinets. Medication administration forms were reviewed.
Isolation area is the Church office area, an additional mat is in place for the sick child and the bathroom, located behind the reception area shall be used during this time

The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through water pitchers as well as individual sports bottles if they prefer
· 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
· Napping equipment: Cots are used and are stored in the corner of the room. Napping linens are brought from home
· Facility shall provide two snacks through the day, while lunch shall be brought from home and stored in their individual bags in their cubbies.

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)
· 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)
· COVID Posters (Page 2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020

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: LITTLE BIG PRESCHOOL	FACILITY NUMBER: 304371456
	VISIT DATE: 12/18/2020

NARRATIVE

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The indoor space: There is one assigned Preschool room with one toilet and one sink inside the classroom.

Dream room: 31’67” X 23’58” = 746’78”

Total Indoor space: 746’ 78” divided by 35= 21.34
(Capacity requested: 15)

Total sinks: 1 X 15= 15 (children)
Total Toilets: 1 X 15= 15 (children)

Facility has no outdoor open space but have a designated playroom adjoining the classroom. It is enclosed and has been set up with age appropriate outdoors toys, it is a multipurpose room and can be utilized for additional activities.

The following were inspected in the Indoor activity space; (Play room)
· Room is carpeted and has enough space to accommodate the desired capacity
· It has age and size appropriate equipment, and outdoor activity toys (bikes)
· The center stage is covered with smooth rounded edges.

Indoor activity room (Playroom)
Playroom: 47’25”X 29’83” = 409’47”

Total Outdoor space: 409’ 47” divided by 75 = 18’79” (18 children)

Based on the indoor measurements, sink and toilet availability, facility has enough space to accommodate the requested capacity for 15 children in the assigned one classroom (Dream Room and Playroom designated for Indoor activity room).

Fire clearance received from Orange County Fire Authority on 12/11/20 have approved the requested capacity of 15 children. (Page-3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020

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: LITTLE BIG PRESCHOOL	FACILITY NUMBER: 304371456
	VISIT DATE: 12/18/2020

NARRATIVE

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Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through January 2021 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component)

Facility has completed the new Water testing requirement and the analytical report is on file

LPA discussed with the applicant 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 was advised the children's bedding must be stored individually and may not touch another children's bedding.

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 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 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

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the applicant/facility representative.
English: http's//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf (Page-4)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020

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: LITTLE BIG PRESCHOOL	FACILITY NUMBER: 304371456
	VISIT DATE: 12/18/2020

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Spanish: http's//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative.

The facility was following Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has enough activity space to support the capacity of 15 Preschool children Age 2-6 years in one designated classroom (Dream room and Indoor activity shall be held in designated Playroom). A license will be issued for the capacity requested after a final review. The applicant will be notified if any additional information is required.

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
Exit interview was conducted and a copy of this report was provided to the director on this date.

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: 12/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020

LIC809 (FAS) - (06/04)

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