Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370807
Report Date: 01/11/2018
Date Signed: 01/11/2018 05:26:00 PM

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:RENASCENCE SCHOOL INTERNATIONAL PRESCHOOLFACILITY NUMBER:
304370807
ADMINISTRATOR:TORJESEN, SOPHIAFACILITY TYPE:
850
ADDRESS:2987 MESA VERDE EASTTELEPHONE:
(714) 336-8015
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY:60CENSUS: 16DATE:
01/11/2018
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Nathalie Franco, Interim DirectorTIME COMPLETED:
05:40 PM
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LPA Romero was met by Nathalie Franco, Interim Director who assisted in touring LPA inside and outside of the facility. Census was taken outside on the playground where 3 teachers were observing 16 pre-school children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The purpose of the visit was relayed to the licensee.

LPA reviewed the sign in/out books, the kitchen area, cleaning supplies storage, carbon monoxide detector and napping equipment. All toilets were functional and there was paper towels and soap for use after toileting. Furniture was age and size appropriate as well as in good condition. The kitchen area which is shared with the school age children was operable and no infestations were observed. Children bring their lunch from home or there is catered lunch available for purchase. Children also bring their own drinking water and there is a filtered faucet for water refills as needed. Playground equipment is in good repair and there is ample cushioning underneath the play structure. Interim Director is First Aid/CPR certified as well as one additional teacher.

The facility was clean, safe and in good repair at the time of the visit. The equipment and furniture were in good repair and free of sharp edges. Disinfectant, cleaning solutions, chemicals and/or poisons were locked or made inaccessible to the children. Menus were posted as well as they are emailed to parents in the monthly newsletter.
Children's records were reviewed and there was an admission agreement in each file. Staff flies were reviewed and educational background information was available and reviewed. There are no bodies of water or weapons present at the facility.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Christine RomeroTELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2018
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RENASCENCE SCHOOL INTERNATIONAL PRESCHOOL
FACILITY NUMBER: 304370807
VISIT DATE: 01/11/2018
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An exit interview was completed. The report was read out load, reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights 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.

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” must be posted on or adjacent to the door. Failure to post Type A reports for 30 day will result in a Civil Penalty of $100.00
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Christine RomeroTELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2018
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: RENASCENCE SCHOOL INTERNATIONAL PRESCHOOL
FACILITY NUMBER: 304370807
VISIT DATE: 01/11/2018
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This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication which is in a locked box inside of the staff office accessible in the event of an emergency. Medications were up to date and there were no expired medications. Parent consents were inside of each individual bag that contained prescribed and/or over the counter medications. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (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

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. The facility representative was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Transfer Request (LIC9182). The facility representative was informed that they can access the Licensing website at www.ccld.ca.gov The facility representative may request to be added to an email list to receive a quarterly update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov

Information on the web address for nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided.

Licensee is aware that all current and new staff moving forward are required to take the Mandated Reporter Training online which can be found at www.mandatedreporterca.com. All staff must complete the training which is due by 03/31/2018 and will need to be renewed every two years. A copy of the training shall be kept in each staff file and will be reviewed during inspection times.


Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Christine RomeroTELEPHONE: (714) 703-2821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2018
LIC809 (FAS) - (06/04)
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