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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371632
Report Date: 09/24/2024
Date Signed: 09/24/2024 05:18:27 PM

Document Has Been Signed on 09/24/2024 05:18 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:DRAGONFLY ACADEMYFACILITY NUMBER:
304371632
ADMINISTRATOR/
DIRECTOR:		AMY NGUYENFACILITY TYPE:
850
ADDRESS:8762 GARDEN GROVE BLVD. # 102TELEPHONE:
(657) 280-9093
CITY:GARDEN GROVESTATE: CAZIP CODE:
92844
CAPACITY: 51TOTAL ENROLLED CHILDREN: 51CENSUS: 41DATE:
09/24/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Phong Chau, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA) Nguyen Nick Tran conducted an unannounced on site visit in response to Licensee request to re-measure the classroom #2 to change the overall capacity of the facility. LPA met with Licensee Phong Chau, who guided LPA on a tour of the facility. Census was taken in individual classrooms. The overall census observed was 41 preschool children supervised by 5 staff members in 4 different classrooms. During the inspection, it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios.

Based on previous measurement on the pre-licensing report conducted by LPA Malek on 07/24/2023, classroom #2 was measured 393.11 square feet with an encumbered area of 279 square feet, thus, only allowed 104.11 square feet to be used for child care in this classroom.

During today's visit, LPA Tran measured the classroom #2. Classroom # 2 is measured 399.75 square feet. Classroom #2 has one hand washing sink and one counter which measured 7.45 square feet (encumbered). Total square feet for classroom #2 is 399.75 - 7.45 = 392.3 square feet. LPA Tran observed no other encumbered area in classroom # 2, and no modification in all other the classrooms based on facility sketch.

Room # 1 is measured 305.91 square feet (previously measured on pre licensing report)
Room # 2 is re-measured 392.30 square feet (today's measurement)
Room # 3 is measured 416.36 square feet. (previously measured on pre licensing report)
Room # 4 is measured 418.60 square feet. (previously measured on pre licensing report)
Room # 5 is measured 551.93 square feet. (previously measured on pre licensing report)
Total indoor activity measurement is: 2,085.1 square feet divided by 35 square feet = 59.57
(59 children).
(Continue next page)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: DRAGONFLY ACADEMY
FACILITY NUMBER: 304371632
VISIT DATE: 09/24/2024
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(Page 2 of Report)

Fire clearance received from Orange County Fire Authority approving the capacity for 54 children. Today's measurements of the facility had enough indoor capacity for 59 children.

Based on today’s indoor and outdoor measurements, the sinks and toilets availability, the capacity of 54 preschool children ages 2 to 5 years old in five rooms (room 4 and 5 combined) will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required. Exit interview conducted and report was reviewed with the Licensee Phong Chau.

Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with licensee Phong Chau.

(End of Report)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024
LIC809 (FAS) - (06/04)
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