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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371709
Report Date: 03/10/2025
Date Signed: 03/10/2025 01:06:41 PM

Document Has Been Signed on 03/10/2025 01:06 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:PRIMUS STUDENT ACADEMYFACILITY NUMBER:
304371709
ADMINISTRATOR/
DIRECTOR:		OH, KYUNGMIFACILITY TYPE:
860
ADDRESS:6071 HOMEWOOD AVENUETELEPHONE:
(714) 336-2818
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY: 33TOTAL ENROLLED CHILDREN: 33CENSUS: 0DATE:
03/10/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Applicant Kyungmi OhTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 03/10/2025 at 9:30am, Licensing Program Analyst (LPA), R. Castanon conducted an announced Pre-Licensing inspection for a new single license. Upon arrival, LPA met with Applicant Kyungmi Oh. Applicant Mrs. Oh is requesting to be licensed for 33 school-age children 5-12 years old in Green Room, Red Room, Blue Room. Hours of operation will be Monday-Friday 2:30pm-6:00pm, early school dismissal days 12:00pm-6:00pm and non-school days will be 8:00am-6:00pm.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Applicant Mrs. Oh that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. Applicant Mrs. Oh does not plan to keep medications on site. A fully equipped first aid kit is on the top shelf in kitchen area. There is an operational carbon monoxide detector on site located in the Blue Room that was tested by LPA during visit. All required licensing documents were observed posted in the entrance of the facility where the children will also be signed in and out.

LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured 853.80 square feet, which is not sufficient to accommodate the requested capacity of children. Updated LIC200A will be submitted to reflect 24 children. LPA observed all indoor activity space to be complete with safe age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via filtered water system dispenser. 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 02/06/2025. Updated fire clearance request will be needed for capacity of 24 children.

LPA observed a total of 3 sinks and a total of 3 toilets available for children’s use. These are sufficient to accommodate the updated capacity of 24 children. Restrooms do not afford privacy for children. Applicant Mrs. Oh will submit photos of privacy walls between the children’s toilets. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the “Director’s Office” which is a converted storage room detached from the building. Isolation restroom will be the staff restroom. (Cont. to page 2)

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2025
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: PRIMUS STUDENT ACADEMY
FACILITY NUMBER: 304371709
VISIT DATE: 03/10/2025
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Facility will provide AM/PM snack and lunch on non-school days and early dismissal. The kitchen area currently includes refrigerator, 3 rice cookers, instant pot, microwave, air fryer, electric hot plate, blender, filtered water system dispenser and extra liquid dispenser. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. Hazardous items in kitchen are inaccessible to children via door lock.

The facility currently has a fully fenced playground area which is separate from other components. Wood fencing is at least four feet high. The total square footage for all the outdoor activity space is 5,103.00 square feet, which is sufficient to accommodate the updated requested capacity of 24. Shade is provided via building overhang. Applicant Mrs. Oh will send LPA photos of additional shade structure. There are no climbing structures located on the playground. The playground is a large grassy area with a sandbox and wood deck. Drinking water is available via filtered water system dispenser. LPA observed all hazardous items on the playground to be inaccessible to children. Applicant Mrs. Oh 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).

Applicant Mrs. Oh 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.

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) 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

LPA reviewed with Applicant Mrs. Oh the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted. (Cont. to page 3)

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
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: PRIMUS STUDENT ACADEMY
FACILITY NUMBER: 304371709
VISIT DATE: 03/10/2025
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Applicant 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. Updated LIC200A and Fire Clearance reflecting new capacity of 24.
2. Privacy walls for children’s restroom
3. Additional outdoor shade structure
4. Full and final review of application packet

Applicant Mrs. Oh understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

Exit interview conducted and report was reviewed with Applicant Kyungmi Oh.

(End of Report)

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
LIC809 (FAS) - (06/04)
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