Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370772
Report Date: 01/22/2020
Date Signed: 01/22/2020 11:02:25 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:18CENSUS: 18DATE:
01/22/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:DirectorTIME COMPLETED:
09:45 AM
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An unannounced case management inspection was conducted today by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek who met with the director Fashana Afaz. This facility has requested to increase their capacity from 18 infants and toddlers to 63 infants and toddlers by adding 3 additional rooms from suit # 34. The facility is currently licensed for 18 infants and toddlers in room # 1 and 4 (Room # 1 for toddlers and room # 4 for infants in suite 35).The main entrance is from suite # 35 for infant/toddler and preschool programs.
Today census was taken. There were a total of 18 infants and toddlers with 6 staff in 2 different rooms. There were three staff with 10 infants in infant room # 4. No infants was napping in the nap area. There were three staff supervising 8 toddlers in the toddler room # 1. On 1/9/2020 LPA made an inspection based on the fire clearance approval received in our office on 1/8/2020. The new rooms 8, 9, 10 were measured on that day to be added to existing rooms of 1 and 4. The Fire Department notified LPA that the fire approval needs to be revised due to some changes that the facility was needed to do. According to a revised fire clearance approval dated 1/15/2020 the facility is allowed to use the rooms that have direct exits to the exterior of the building for the children under 24 months old. Therefore the facility is given a provisional license to use rooms 4 and 8 for children under 24 months old until a final fire clearance is issued by the Fire Department. The measurement of room # 4 and 8 are as following:

Room # 4 is approximately 350 square feet after deducting the crib area which accommodates 10 children under 24 months old.
Room # 8 is approximately 420 square feet after deducting the crib area which accommodates 12 children under 24 months old.
Based on the revised fire clearance approval, a provisional license is issued for rooms 4 from suite # 35 and room # 8 from suite 34 for a total of 22 children under 24 months old.
Continued on page 2
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HAPPY MINDS KIDS ACADEMY
FACILITY NUMBER: 304370772
VISIT DATE: 01/22/2020
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There are a total 7 sinks and 3 additional toilets in the new added space which are adequate for the given capacity.
As of 1/15/2020 according to fire department, the facility has been given 45 days to make some changes to retain fire clearance. After receiving the final approval from Fire Department, the status of the license, capacity, and new room changing will be reflected on the final issued license.
According to the measurement of 10/23/2017 the playground measurement for infants and toddlers is approximately 1844 square feet which accommodates 24 infants and toddlers.
The Notice of Site Visit was posted. 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. The licensee was provided a copy of their appeal right (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. First level appeal is to Regional Manager, address is above on the report. The facility representative was informed that they can refer to our Department website at www.ccld.ca.gov for obtaining the quarterly updates.
Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

A copy of child care provider's guide to safe sleep pamphlet and a copy of Never Ever Shake a Baby pamphlet with the website www.dontshake.org were given to the facility representative on the last inspection date.
An updated pamphlet regarding safe sleep regulations in childcare and a pamphlet for lead poisoning facts were given to the director on the last inspection date.


In the areas that were evaluated, the facility was in compliance of the California Code of Regulations, Title 22, Division 12. No deficiency was cited.

This report ends here.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
LIC809 (FAS) - (06/04)
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