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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371572
Report Date: 08/02/2022
Date Signed: 08/02/2022 01:04:17 PM

Document Has Been Signed on 08/02/2022 01:04 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:TUSTIN PRESCHOOLFACILITY NUMBER:
304371572
ADMINISTRATOR:REN, YULANDFACILITY TYPE:
850
ADDRESS:1421 NEWPORT AVENUETELEPHONE:
(714) 838-3480
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 16DATE:
08/02/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Facility Director Ms. Trujillo, JeanetteTIME COMPLETED:
01:15 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 New center. LPA met with the Facility Director Ms. Trujillo, Jeanette who gave a tour of the Child Care Center. It is a Change of Ownership an Emergency Approval to operate was issued by the Department, valid up to August 9th 2022.

The applicant has requested to provide care and supervision for 45 Pre-school age children 2 to 6 years of age, Monday through Friday 6:30 AM. to 6.00 PM. in the assigned classrooms (Room # 1,2,3,4 & kitchen play area)

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, children shall be received at the entrance door of the facility facing the parking lot. Parents sign in manually on the sign in board and children are guided to their individual rooms. Upon arrival each child has an health evaluation along with hand washing before they participate in the classroom activities.

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.

Isolation area: Is the Director's office and there is an additional cot with linens for the sick child.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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: TUSTIN PRESCHOOL
FACILITY NUMBER: 304371572
VISIT DATE: 08/02/2022
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LPA discussed the posting requirements including, but limited to, the following: ( Posters are posted at the entrance of the facility)

· 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:
· 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 (Manual sign in and out)
· Facility has smoke detector, carbon monoxide detector, and fire extinguishers mounted in the side walls of the classroom that meet statutory requirements including a Fire Alarm system.
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Cots are used and are stored in a separate storage area, napping linens and blankets are provided by the parents, facility also has additional linens if needed.
· Facility provides AM/PM snacks, and lunch is catered through a company :Cater Tots" and parent have an option to bring lunch from home also. 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.
Children have access to various activities arranged in the classroom.
(2)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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: TUSTIN PRESCHOOL
FACILITY NUMBER: 304371572
VISIT DATE: 08/02/2022
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LPA measured the four assigned Preschool rooms and the kitchen play area.

Indoor activity space : 1672'45 divided by 35 = 47'78 (48 children)
Facility has sufficient indoor activity space to accommodate the requested capacity of 45 children.

Total sinks : 3 X 15= 45 children / Total Toilets: 3 X 15= 45 children ( There is also one additional adult toilet and sink, which shall be used by a sick child) Facility has communal toilets with two sinks inside and one additional sink in Classroom # 3 assigned to older children and step stool is available.

Facility has age appropriate sinks and toilets meeting the requirements.

Preschool outdoor play yard:



Facility has designated Preschool yards and following was observed:
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers, water fountain 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 soft cushioning (wooden chips) is in place under the play structure to absorb the falls
· Adequate shade is provided by shaded structure (covered shaded area & trees )and roof line shade.
· There is also a bike trail area and a concrete open area for children to play. Children shall walk through the passage area, adjoining classroom # 2 & 3 to access the play yard.

The play structure is appropriate for ages of the preschool to be served.
There is a fenced gate at the end of the shaded play yard, it has a lock but the gap in-between the two fenced gate is wide and needs to be corrected, and the Exit door also needs a door alarm to know if the door is opened accidentally.

Play yard also has sufficient shade and activities for children. (3)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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: TUSTIN PRESCHOOL
FACILITY NUMBER: 304371572
VISIT DATE: 08/02/2022
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Total outdoor activity space: 5442'56 divided by 75 = 76'77

Based on the indoor / outdoor measurements, sink and toilet availability, facility has sufficient space to accommodate the requested capacity of 45 Preschool age children (2-6 years old) in the assigned four classrooms with kitchen play area.

Fire clearance received from Orange county Fire Authority approving the requested capacity of 45 children
in the assigned four rooms along with kitchen play area.

Director Ms. Trujillo, Jeanette is current on the required Immunization/ Pediatric CPR/ First training valid through August 21, 2023 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 : Facility Director Ms. Trujillo, Jeanette 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.

Safe Sleep : LPA discussed the safe sleep regulations with Facility Director Ms. Trujillo, Jeanette discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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. (4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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: TUSTIN PRESCHOOL
FACILITY NUMBER: 304371572
VISIT DATE: 08/02/2022
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APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated 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 : LPA reviewed with Facility Director Ms. Trujillo, Jeanetter, 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.

Facility at the time of inspection is not in compliance with Title 22 regulation. Following corrections are needed to make the facility safe for children.


(1) Door Alarm on the Exit door across Classroom # 3.
(2) Cover the broad gaps and bottom section of the metal fenced gate at the end of the play yard.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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: TUSTIN PRESCHOOL
FACILITY NUMBER: 304371572
VISIT DATE: 08/02/2022
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A license for 45 Preschool age children (2-6 years old) in assigned four classrooms with Kitchen play area, Monday to Friday 6.30 am to 6.00 pm shall be approved upon receiving the corrections from the facility Director.

Report was read and Appeal Rights were presented.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
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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