304371593-9-6-2022-06-CC-MMAK-CHZUKD-20220906153859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371593
Report Date: 09/06/2022
Date Signed: 09/06/2022 03:39:11 PM

Document Has Been Signed on 09/06/2022 03:39 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:	ORANGE CRESCENT PRESCHOOL		FACILITY NUMBER:	304371593
ADMINISTRATOR:	SHARIFF, FAZREEN		FACILITY TYPE:	850
ADDRESS:	9752 13TH STREET		TELEPHONE:	(714) 531-1991
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92844
CAPACITY:	24	CENSUS: 0	DATE:	09/06/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Director		TIME COMPLETED:	04:15 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	Page 1 of 5 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced on site pre-licensing inspection at this childcare center for the purpose of opening a preschool center. This facility runs by the same management and director at facility # 300605670 and the address of 9802 13th Street. Additional 24 preschool children has been requested at this address in room # 1 building 2. According to Fire Department, this room is not included in the same address of the other school. This new room has a different address but is close to the other preschool. Per Licensing Regulations each address requires a new license number. Therefore the facility # 300605670 located at 9802 13th Street of same management will run 24 preschool children in room # 1 in building 2 located at 9752 13th Street. The applicant runs the facility # 300605670 at 9802 13th Street for a capacity of 67 children including 11 toddlers from Toddler Option Program and additional 24 preschool children in room # 1 in building 2 at the address of 9752 13th Street, facility # 304371593. Both facilities use the same playground and are located at the ground of Islamic Society of Orange County (ISOC). LPA met with the director, Fazreen Shariff. The director gave LPA a tour of the new preschool classroom on this premises. (Room # 1 building 2). Facility has requested for 24 preschool children in one classroom. The applicant has requested to provide care and supervision for 24 pre-school children ages 3 to 5 years old, Monday through Friday 8:00 AM to 6:00 PM. LPA advised the director to follow the CDC and Dept of Public Health Guidelines due to COVID Pandemic. 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 Continued on page 2

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: ORANGE CRESCENT PRESCHOOL	FACILITY NUMBER: 304371593
	VISIT DATE: 09/06/2022

NARRATIVE

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clearances or exemptions.

LPA discussed the posting requirements including, but not 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.
Posters are posted at the entrance, in the lobby.

The following were inspected in the indoor activity space (Classroom # 1 building 2):
· Classroom is adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through personalized water bottles, pitcher and Dixie cups.
· Sign in/Sign out procedure was reviewed.
· Facility has in-built smoke detectors & carbon monoxide detector.
· Cubbies available for storage of individual child’s personal belongings
· Napping equipment: Children in this program will nap on cots, beddings and blankets will be provided by the parents and washed weekly. Additional sheets are available if needed.
· Facility has a full day and part day program. The parents provide AM/PM snacks and lunch to children. The parents have the option to buy outside catering lunch.
Room is well lighted with proper ventilation
There are two sinks in this classroom. There is also a restroom with two toilets located in this room.
Medications are stored in the locked box . First Aid kit and Emergency kit is present and inspected.

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: ORANGE CRESCENT PRESCHOOL	FACILITY NUMBER: 304371593
	VISIT DATE: 09/06/2022

NARRATIVE

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LPA measured the Preschool classroom (Room 1 of building 2).

Indoor activity space : 959.95 square feet divided by 35 = 27.43 (accommodating 27 children).

Total toilets and sinks: : Total sinks 2 X 15= 30 children / Total Toilets: 2 X 15= 30 children

Facility has age appropriate sinks and toilets inside the classrooms to meet the needs of 24 preschool children.

Preschool outdoor play yard:

Facility has designated Preschool yard outside preschool rooms and following were observed:

· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by personal water bottles, pitcher and Dixie cups.
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structure, slide and outdoor activity toys and equipment.
· An adequate amount of cushioning material such as turf.
· Adequate shade is provided by 2 large umbrellas and building shade.

The play structure is safe for the age group to be served (2-6 years old).

Outdoor activity space: 3630 square feet divided by 75 =48.41 (accommodating 48 children)
An approved waiver for preschool children to share the playground with private kindergarten using staggered schedules is in place. New waiver is not needed.

Based on the indoor /outdoor measurements, sink and toilet availability, facility has sufficient space to accommodate 24 preschool children in classroom # 1 of building 2.
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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: ORANGE CRESCENT PRESCHOOL	FACILITY NUMBER: 304371593
	VISIT DATE: 09/06/2022

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Fire clearance received from OC Fire Authority approving the capacity of 24 children in room # 1 of building 2 at 9752 13th Street which runs by the same management of the preschool license # 300605670 at 9802 13th Street. Both addresses are on the same ground of Islamic Society of Orange County (ISOC).

The document for Director, Fazreen Shariff is current on the required Immunization/ Pediatric CPR/ First training and has 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 : Fazreen Shariff 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 Fazreen Shariff 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 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

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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: ORANGE CRESCENT PRESCHOOL	FACILITY NUMBER: 304371593
	VISIT DATE: 09/06/2022

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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 Fazreen Shariff 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.

A license for 24 preschool age children (3 to 5 years) in classroom # 1 of building 2, Monday to Friday from 8.00 am to 6:00 pm will be issued after completing the following items and final review at our office:

(1) Association of staff to this new facility through Guardian.
(2) Updated LIS 309
(3) Board resolution letter for Fazreen Shariff,
Report read and appeal rights presented to Director, Fazreen Shariff.
End of the reports

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC809 (FAS) - (06/04)

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