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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371602
Report Date: 03/24/2023
Date Signed: 03/24/2023 12:24:17 PM

Document Has Been Signed on 03/24/2023 12:24 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:TAMPOPO BILINGUAL CHILDREN CENTERFACILITY NUMBER:
304371602
ADMINISTRATOR:HASEGAWA, YURIKOFACILITY TYPE:
850
ADDRESS:2000 NORTH FAIRVIEW STREETTELEPHONE:
(310) 666-5126
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 0DATE:
03/24/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:ApplicantTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced on site pre-licensing inspection at this location for the purpose of opening a new preschool program. The preschool is located on the ground of Wintersburg Presbyterian Church of Santa Ana. LPA met with the Applicant/Director, Yuriko Hasegawa. LPA was given a tour by the applicant of the entire facility.

The applicant has requested to provide care and supervision for 36 preschool children ages 2 to 6 years old, Monday through Friday 7:30 AM to 6.00 PM.

LPA observed the facility is following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements.

Parents sign in and out at the entrance of the building. The entrance is from the front side of the building entering from parking lot to a playground and Atrium/lobby, and 3 other classrooms. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities.

Isolation area is in the Atrium/lobby adjacent to preschool office area located at the entrance of the facility with additional mats with beddings are provided for the sick child until the child is picked up. The bathroom for sick children is an additional bathroom inside the preschool office not used for children and staff and only used for sick children. One staff person stays with the sick child/children at all times.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TAMPOPO BILINGUAL CHILDREN CENTER
FACILITY NUMBER: 304371602
VISIT DATE: 03/24/2023
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· 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)
Safe sleep posters / SIDS

The following was observed in the classrooms:
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through children's own water bottles and facility's water bottles.
· Sign in/Sign out procedure was reviewed.
· Facility has in-built smoke detectors. There is fire extinguisher mounted that meets statutory requirements. Carbon Monoxide Detector will be provided,
· Cubbies available for storage of individual child’s personal belongings.
· Napping equipment: Children in this program will nap on cots, beddings will be provided by the parents and are washed weekly by parents.
· Facility has a full day and part day program and parents will provide AM snacks, and facility provides PM snacks, and lunch will be optional either through a catering agency or parents bring lunch to children.
Rooms are well lighted with proper ventilation.
Medications are stored in the locked area if any.
First Aid kit and Emergency kit is present.
Children in CM4 is for younger children who will be diaper changed in the classroom on a mat. The director was reminded of sanitizing the mat each time before and after use and washing hands procedures.
No food preparation at this site. There is a refrigerator and freezer in the kitchen room.
There are additional snack available at site in case a child has forgotten his/her snack or needs more.
Continued on page 3
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TAMPOPO BILINGUAL CHILDREN CENTER
FACILITY NUMBER: 304371602
VISIT DATE: 03/24/2023
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LPA measured the classrooms and the measurements are as below:
Atrium/Lobby Room Unit A is 316.84 square feet
CM4 is 271.83 square feet
CM5 is 361.75 square feet
CM6 is 362.52 square feet

Total indoor capacity for the Atrium/Lobby and 3 classrooms are: 1312.77 square feet divided by 35= 37.51 (38 children)
Total sinks: 3 X 15= 45 children.
Total toilets: 5 X 15=75 children. One toilet and sink is adjacent to CM4
Children shall be escorted by a staff person to and from the restrooms.

Playground measurement: Outdoor activity space is 3056 square feet divided by 75 = 40.75
(41 children).
The following was observed for outdoor space:
· The Playground is fully enclosed by appropriate fencing at least 4 feet high. There are 3 gates on this playground opening to the court yard of the church leading to parking lot. The gates are equipped with push bars. The director advised to have additional lock on the top of the gate for extra caution. LPA discussed the supervision and staff stationing on the playground to watch out for the exit gate on the playground.
· Outdoor activity space is supplied with age and size appropriate equipment.
· There are climbing structure on the playground which will be added with adequate cushioning materials.
Shade is provided by awnings .
Drinking water is provided by children's own water bottles and facility water bottles.
Fire clearance received from Orange County Fire Authority approving the requested capacity of 36 preschool children. The total measurements of the Atrium/Lobby and 3 preschool classrooms accommodate the requested capacity.
The director, Yuriko Hasegawa. is current on the required Immunization/ Pediatric CPR/ First training, the Preventive Health training (Nutrition and Lead component) and Mandated Child abuse reporting training certificate.
Continued on page 4
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TAMPOPO BILINGUAL CHILDREN CENTER
FACILITY NUMBER: 304371602
VISIT DATE: 03/24/2023
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Criminal Record Statement : The Applicant, Yuriko Hasegawa 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 applicant 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 the applicants 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) 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

LPA reviewed the LIC 311A, Records to Be Maintained at the Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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.

Continued on page 5

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TAMPOPO BILINGUAL CHILDREN CENTER
FACILITY NUMBER: 304371602
VISIT DATE: 03/24/2023
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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 36 preschool children age 2 to 6 years old, Monday to Friday 7:30 am to 6:00 PM in rooms Atrium, CM103, 1044, CM5, and CM6 will be issued after receiving the following corrections, final review, and management approval. The applicant will be notified if any additional documents are needed before issuing a license. On today's inspection, the director submitted/corrected additional documents to LPA which was requested. Please send the following within 30 days of today's date.


1- Securing the cubbies in classrooms CM4, CM5, and CM6 to the wall.
2- Installing additional latch/lock on the top of all the 3 exit gates leading to the church's courtyard, and parking lot for extra cushion. One exit gate leading to the parking lot has additional gate as a second barrier.
3- Installing Carbon Monoxide Detector.
5- Posting requirements
6- Providing cushioning materials under and around falling zones of the play structure on the larger playground. The side playground has adequate cushioning (Turf).
7- Providing napping equipment.
8- A sample of sing in and out sheet.
9- Exit doors in CM4, CM5, and CM6 have exit doors leading to the parking lot equipped with alarm devices. Please provide child proof doorknobs on the handles of these doors. (Total of 3)
10- Shade for the playground.
Exit interview conducted and report was reviewed with the Applicant, Yuriko Hasegawa.
End of reports
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC809 (FAS) - (06/04)
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