Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370772
Report Date: 09/06/2017
Date Signed: 09/06/2017 11:23:42 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:HAPPY MINDS KIDS ACADEMYFACILITY NUMBER:
304370772
ADMINISTRATOR:AFAZ, FASHANAFACILITY TYPE:
830
ADDRESS:24000 ALICIA PARKWAY # 35TELEPHONE:
(949) 455-1212
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:16CENSUS: 15DATE:
09/06/2017
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:31 AM
MET WITH:Ms. AfazTIME COMPLETED:
11:40 AM
NARRATIVE
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Complaint Specialist (CS) Hundley and Licensing Program Analyst (LPA) Romero conducted a case management inspection to review the facility. During the inspection CS and LPA toured the classrooms and noticed one staff caring for 6 infants who were in the activity area. One of the infants was sleeping in a swing. There was another staff inside the napping area caring for 2 infants who were napping in the cribs. CS and LPA discussed infant ratio and napping ratio with the director and staff. Facility staff are to meet the 1 to 4 ratio at all times. Infant who are napping are to be placed in the cribs and not left unattended. The facility was not in compliance and violation(s) of the California Code of Regulations, Title 22, Division 12 were observed, discussed and cited at the time of the visit.

Upon receipt of Type A violations, the licensee shall post and provide copies of this facility report to parents/guardians of the children in care at the facility, and to the parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee is to keep Acknowledgement Receipt signed by parents in each child’s file. The licensee may use the LIC 9224 for parent’s to sign as a receipt

An exit interview was completed. Appeal Rights and deficiencies were discussed. All appeals must be in writing and received by the Licensing office within 15 days. A copy of the Appeal Rights was given to the director. AB 633 fact sheet was given to, and discussed with, the facility representative this date.

THE FACILITY REPRESENTATIVE WAS INFORMED THAT THE 'NOTICE OF SITE VISIT' MUST BE POSTED FOR 30 CONSECUTIVE DAYS. FAILURE TO POST WILL RESULT IN CIVIL PENALTIES OF $100.00. THE 'NOTICE OF SITE VISIT' WAS POSTED ON THE DOOR.

Flyers given: Safe Sleep practices for infants and Don’t shake a baby PUB273.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2017
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HAPPY MINDS KIDS ACADEMY
FACILITY NUMBER: 304370772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/06/2017
Section Cited
CCR
101416.5(b)
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Staff-Infant Ratio: There shall be a ratio of one teacher for every four infants in attendance. One staff was caring for 6 infants while the other staff was inside the napping area with 2 infants who were napping in their cribs. Facility is not meeting 1:4 ratio with infants who are in the activity area. This poses an immediate Health and Safety risk to the children/clients in care.
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Director stated she will have staff training and will have staff review the E-Learning module regarding teacher child ratios in child care centers. A written correction will be sent with confirmation of the E-Learning viewing and what was understood by staff.
Type A
09/06/2017
Section Cited
CCR
101223(a)(2)
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Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
An infant was observed swaddled, strapped in and napping in a swing which was located in the activity area. This poses an immediate Health and Safety risk to the children/clients in care.
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Director stated she will have staff training and will have staff review the E-Learning module regarding personal rights of children. A written correction will be sent with confirmation of the E-Learning viewing and what was understood by staff.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2017
LIC809 (FAS) - (06/04)
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