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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371697
Report Date: 08/20/2024
Date Signed: 08/22/2024 10:41:52 AM

Document Has Been Signed on 08/22/2024 10:41 AM - 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:BROADWAY HEAD STARTFACILITY NUMBER:
304371697
ADMINISTRATOR/
DIRECTOR:		ALVAREZ, ROSEFACILITY TYPE:
860
ADDRESS:321 WEST WASHINGTON AVENUETELEPHONE:
(714) 241-8920
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 0DATE:
08/20/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Rose Alvarez, Director and V. Padilla, ApplicantTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 08/20/2024 at 1:00pm, Licensing Program Analyst (LPA), R. Castanon and P. Rivas conducted an announced Pre-Licensing inspection for a new license. Upon arrival, LPA met with Applicant, Ms. Padilla and Director Ms. Alvarez. Applicant is requesting to be licensed for 40 preschoolers ages 2-5 years old in Rooms 1 & 2. Hours of operation will be Monday – Friday, AM Session from 7:30am – 5:30pm.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Ms. Padilla that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. All exits need to be secured. When medications are on site, Ms. Alvarez stated that they will be in a backpack up high in each classroom.. A fully equipped first aid kit is located in the medication cabinet and a backpack hung near the backdoor entrance. There is an operational carbon monoxide detector on site located in each classroom. All required licensing documents were observed posted . Children will be electronically signed in using Child Plus in each classroom. A hard copy can be provided to LPA during visit. If system fails, a hard copy will be completed. .

LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured 2569.51 square feet, which is sufficient to accommodate the requested capacity of 40 children. LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cots , cubbies, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via filtered water pitchers. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 07/31/24 I4.

Each classroom has it's own bathroom. In Room1 LPA observed 2 toilets, 2 sinks and a hopper sink. In Room 2 LPA observed 3 toilets, 5 sinks for children's use, there is a sink available for adults and one hopper sink. There are sufficient toilets and sinks to meet the requested capacity. (Continue to page 2)

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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 3
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: BROADWAY HEAD START
FACILITY NUMBER: 304371697
VISIT DATE: 08/20/2024
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The isolation area for children who are ill will be the Director's office. The bathroom will be one of the staff restrooms which is located directly across the Director's office.
Facility will provide breakfast, lunch and snacks obtained through Great American Lunch Box. There is currently a kitchen/staff lounge which has refrigerator, microwave, dishwasher. Cleaning solutions will be kept in locked closet inside the kitchen/staff lounge..

The facility currently has a fully fenced playground area. The brick fence is at least four feet high. The total square footage for all the outdoor activity space is 3765.84 square feet which is sufficient to accommodate the requested capacity. Shade is provided via canopy, pergula. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is a climbing structure on the playground which is properly anchored. Ms. Padilla the structure was age appropriate for the ages being served. There is adequate cushioning in fall zones of climber provided by pour and play. Drinking water is available via filtered water jugs. LPA observed all hazardous items on the playground to be inaccessible to children. Applicant Ms. Padilla was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

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).



Ms. Padilla 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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 was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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.. (Continue to page 3)

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

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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: BROADWAY HEAD START
FACILITY NUMBER: 304371697
VISIT DATE: 08/20/2024
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LPA reviewed the LIC 311A with Ms. Padilla, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.


Ms. Padilla was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. To receive important licensed 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.

The following corrections are needed prior to the issuance of the license:
  1. Hot water temperature to measure within 105 and 120 degrees.(video wil be provided)

Ms.Padilla understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied. A license for 40 children will be granted upon a final file review.

Exit interview conducted and report was reviewed with the applicant Valerie Padilla.

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

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
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