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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371689
Report Date: 07/03/2024
Date Signed: 07/03/2024 01:13:19 PM

Document Has Been Signed on 07/03/2024 01:13 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:TRF ANNE BROUSSARD ECEFACILITY NUMBER:
304371689
ADMINISTRATOR/
DIRECTOR:		MEJICO, DANETTEFACILITY TYPE:
860
ADDRESS:1825 WEST CIVIC CENTER DRIVETELEPHONE:
(714) 333-0199
CITY:SANTA ANASTATE: CAZIP CODE:
92703
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: 0DATE:
07/03/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Renee Jacobs, CEO, Danette Mejico, CPOTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) P Rivas met with Renee Jacobs, CEO, Danette Mejico, Chief Program Officer, Michelle Patrick, Site Supervisor for the purpose of conducting a pre licensing inspection. The facility is located within the El Salvador Recreation Community Center. The applicant is requesting to be licensed for 15 infants ages zero to two years old and 32 preschoolers ages two to five years old. The rooms requested to be licensed are the infant room, early preschool and preschool room with an outside activity space. Hours of operation are Monday through Friday 7:30am to 5:30 pm.
The City of Santa Ana operates the swimming pool on site which remains locked when not in use. There is a self latching gate that latches well above 5 feet, it is surrounded by a 30 foot fence. Applicant will not be using pool.
There is a city operated a summer day camp room located in between the infant room and the pre school room.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Ms. Mejico that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. Also that all exits are properly secured. When medications are on site, Ms Mejico stated that they will be in infant room including refrigerated medication. A fully equipped first aid kit is in each room. There is an operational carbon monoxide detector on site located in each room. All required licensing documents were observed posted near sign in area in each room. Children will be signed in and out at entrance of each room.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2024
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 4
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: TRF ANNE BROUSSARD ECE
FACILITY NUMBER: 304371689
VISIT DATE: 07/03/2024
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LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured 2155.03 square feet. which is sufficient to accommodate the requested capacity of 47 Children (15 infants and 32 preschoolers). LPA observed all indoor activity space to be complete with age-appropriate furniture and equipment, including tables, chairs, cubbies, cribs, or napping cots for infants who can climb out of a crib, bookshelves, and other activity supplies for the children. LPA observed six cribs and 9 cots, four potty chairs. Applicant reports they will always meet the need of the children accepted into care, which includes providing them with a crib or cot . LPA observed a Diaper changing tables in infant room and early preschool. The changing tables had 3 inch sides, padding was at least one inch and are within the arms reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area is separated from activity space via movable partitions. This barrier is at least four feet high, made of sound absorbing material and allows for supervision of napping children. Sleep logs are kept in infant area. Needs and Services Plans and Sleep Plans are kept in infant room and child's file.

There is at least one potty chair or toilet for every five infants. LPA observed a total of 5 sinks available for children’s use. These are sufficient to accommodate the requested capacity of 15 infants and 32 preschool children. There is a separate staff restroom within the community center.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRF ANNE BROUSSARD ECE
FACILITY NUMBER: 304371689
VISIT DATE: 07/03/2024
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The isolation area for children who are ill will be the infant room near the sink and will use one of the toilets and sinks in bathroom and will be sanitized after use.
Toys are safe with no sharp edges, splinters, or points, nor made of small parts that can present a choking hazard. Drinking water is available in the classrooms via water filter system. LPA observed all hazardous items to be inaccessible to children. Fire clearance was granted on 06/11/24.

Facility will provide all meals and snack will be brought into facility.



The facility currently has a fully fenced playground area which is separate from other components. Fencing is brick and chain link and iron sections which are least four feet high. The total square footage for all the outdoor activity space is 1979.08 square feet which is insufficient to accommodate the requested capacity. A playground waiver to share the playground at different times the AM and PM due to limited square footage shall be submitted and approved prior to licensure. And a waiver for infant use will be submitted. Shade is provided via easy up and trees. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. Drinking water is available via jugs which are filled with water from filtering system.. LPA observed all hazardous items on the playground to be inaccessible to children. Applicant Ms. Mejico was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: TRF ANNE BROUSSARD ECE
FACILITY NUMBER: 304371689
VISIT DATE: 07/03/2024
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

The following corrections are needed prior to the issuance of the license:
1. Waivers for play ground use.(one for insufficient space and one for separate usage)

Applicant/Licensee Representative Danette Mejico understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC809 (FAS) - (06/04)
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