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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371570
Report Date: 08/02/2022
Date Signed: 08/02/2022 06:00:22 PM


Document Has Been Signed on 08/02/2022 06:00 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:MIRACULOUS MILESTONESFACILITY NUMBER:
304371570
ADMINISTRATOR:LUU, JAMIEFACILITY TYPE:
850
ADDRESS:1000 BISON AVENUETELEPHONE:
(562) 381-4803
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92660
CAPACITY:62CENSUS: 15DATE:
08/02/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator Ms. Luu, Jamie & Director Mr. Coccio, Dominique TIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a Change of Ownership, An Emergency Approval License was issued by the department valid up to August 9th 2022.
LPA met with the Owner/ Applicant Ms. Luu, Jamie along with the facility Director Mr. Dominique, Coccio who gave a tour of the Child Care Center on the premises of The Liberty Baptist Church. Four rooms and outdoor play yard is designated to the Child Care Center.

The applicant has requested to provide care and supervision for 44 Pre-school age children 3-5 years of age, along with 18, Toddler option (18 months to 36 months) in the assigned three classrooms Monday through Friday 7:30 AM. to 6.00 PM. (Room # 10, 16 (Preschool age ) Room # 9 (Toddler room) An Infant component with a capacity of 10 has also been requested by the Applicant in one Infant room # 8. Total capacity of 72 children.

LPA observed staff following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements. The entrance door is the access door to enter the Preschool premises, parents shall use a pin code to enter the main entrance of the center, upon entering the facility through the glass door, there is a front lobby area, where the parent shall sign in the child, facility staff member present shall guide the child to the respective classrooms.

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 on the premises of The Liberty Baptist Church and there is Private school on the same premises. LPA have requested a copy of Private School Affidavit certificate. (1)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2022
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: MIRACULOUS MILESTONES
FACILITY NUMBER: 304371570
VISIT DATE: 08/02/2022
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Isolation area is the Director’s office, located adjoining the Toddler room and the sick child shall use the restroom located next to the lobby area there is an additional cots with linens for the sick child.

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.

The following were inspected in the indoor activity space: (Preschool and Toddler room)
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through personalized water bottles and water pitchers in each preschool rooms.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Electronic sign in and out)
· Facility has built in smoke detector, carbon monoxide detector, and fire extinguishers in the hallway 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 under the counter top, without blocking any passage area, napping linens and blankets are provided by the parents, facility also has additional linens if needed.
· Facility provides AM/PM snacks, lunch is brought from home. This containers are labelled and stored in the individual cubbies.
Rooms are well lighted with proper ventilation
Each room has age appropriate activity items and space to move around.
Room # 9 (Toddle room) has a changing pad next to the sink along with small baby toilet and potty chairs for toddlers. (2)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
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: MIRACULOUS MILESTONES
FACILITY NUMBER: 304371570
VISIT DATE: 08/02/2022
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LPA measured the two assigned Preschool rooms (Classroom # 10 and 16)

Indoor activity space : 1553' 52 divided by 35 = 44.39
Facility has sufficient indoor activity space to accommodate the requested capacity of 44 Preschool age children in two assigned rooms

Total sinks : 7 X 15= 105 children / Total Toilets: 6 X 15= 90 children

Facility has age appropriate sinks and toilets designated for Girls and Boys at the entrance, next to the lobby area.

Preschool outdoor play yards : Facility has designated Preschool yard and following was observed:


· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers and personal water bottles
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor activity toys,
· An adequate amount of cushioning material consisting artificial turf is in place under the play structure
· Adequate shade is provided by shaded structure (Canopy), portable umbrella's and roof line shade.
Children and staff shall walk through the lobby area through the main double door to access the play yard, located across the preschool building.
Fencing has no in-between open gaps, there is metal gate with a lock and a key is needed to operate the gate. The handle is at a safe height. There is a dual lock installed on the exit metal gate at the end also.
The play structure on the artificial grass, is appropriate for ages to be served and the label indicates 2 - 5 years of age
Shaded lunch area has been set up for outdoor lunch activity under the wooden canopy.
Total Outdoor activity space (Preschool): 3914'93 divided by 75= 52'20 (52 children)

Based on Indoor/Outdoor / Sink & Toilet availability , Facility has sufficient space to accommodate the requested capacity of 44 Preschool children in two assigned classrooms (Room # 10 and 16)
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
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: MIRACULOUS MILESTONES
FACILITY NUMBER: 304371570
VISIT DATE: 08/02/2022
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Toddler option : Facility has also requested a capacity of 18 Toddlers with the Preschool Program in one designated classroom # 9. LPA measured the Toddler classroom

Indoor activity space: 571' 17 = 16'32 (16 toddlers)

Toddlers have one sink in the classroom along with one toilet and Potty chair in the adjoining bathroom and facility also has designated one sink and one toilet in the Preschool bathrooms.

2 sinks x 15= 30 (children) ( 2 Toilets x 15= 30)

Toddlers shall share the outdoor space with the Infants and Preschool on a rotating basis. A waiver for staggered schedule with Infants shall be submitted by the facility.

Facility requested 18 toddlers, based on the Indoor and sink and Toilet availability for Toddler option children, facility can accommodate only 16 Toddlers in the one assigned room # 9.

Fire clearance received from Costa Mesa Fire Authority approving the requested capacity of 72 children
in the four rooms. ( 44 Preschool age/ 18 Toddlers and 10 Infants)

Applicant Ms. Luu, Jamie is current on the required Immunization/ Pediatric CPR/ First training valid through 4/26/2024 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component and Mandated Child abuse reporting training.

Following items were discussed at the time of Exit interview.
Criminal Record Statement : Applicant, Ms.Luu, Jamie was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MIRACULOUS MILESTONES
FACILITY NUMBER: 304371570
VISIT DATE: 08/02/2022
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Safe Sleep : LPA discussed the safe sleep regulations with Applicant Ms. Luu, Jamie and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant Ms. Luu, Jaimee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) APPLICANT KNOWS FACILITY PLANS TO PROVIDE IMS: This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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

Review of records to be maintained

Child Care Centers :LPA reviewed with applicant, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Subscribe to CCLD important information

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important license-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
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: MIRACULOUS MILESTONES
FACILITY NUMBER: 304371570
VISIT DATE: 08/02/2022
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A license for 44 Preschool age children (3-5 years) in two assigned classrooms # 10 & 16. Along with 16, Toddler option children (18 months to 36 months) in Room #9 (Total capacity 60 children) . Monday to Friday 7.30 am to 6.00 PM, shall be issued upon management approval.

Report read and appeal rights presented to the applicant.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022
LIC809 (FAS) - (06/04)
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