300601652-8-17-2023-06-CC-MMAK-CUSQJF-20230817121241

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300601652
Report Date: 08/17/2023
Date Signed: 08/17/2023 12:12:51 PM

Document Has Been Signed on 08/17/2023 12:12 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	TEMPLE BETH DAVID PRE SCHOOL		FACILITY NUMBER:	300601652
ADMINISTRATOR:	WILSON, NICOLE		FACILITY TYPE:	850
ADDRESS:	6100 HEFLEY ST		TELEPHONE:	(714) 893-3091
CITY:	WESTMINSTER	STATE: CA	ZIP CODE:	92683
CAPACITY: 63	TOTAL ENROLLED CHILDREN: 63	CENSUS: 20	DATE:	08/17/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 of 4 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek and LPA Mila Quinto conducted a case management inspection of the facility for the purpose of the facility increasing their capacity from 63 preschool children to 73 preschool children by adding room 8 to the existing rooms. The facility has been licensed for 63 children in rooms 1, 2, 3, 4, 5, 6, 11, 12, 13, and 15 (Room 1 and 2 is one room, room 10 and 11 is one room, and room 12 and 13 is one room. LPAs met with director, Nicole Wilson who gave LPAs a tour of the facility. The facility is located on the ground of Temple Beth David. There were 20 children present with 6 staff today. The facility has requested to provide care and supervision to 73 preschool children, Monday to Friday from 7:15 am to 6:15 pm. A review of the Facility Personnel Report Summary 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 facility provides morning and afternoon snack and parents provide lunch to children. Children nap in this room on mats. The children are dropped off and are singed in and out at the entrance electronically. The facility has met all the posting requirements. All areas identified on the Facility Sketch were inspected. If children become ill during the day, they will rest in the isolation area located in director's office away from the other children, and use the adult restroom. Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH DAVID PRE SCHOOL	FACILITY NUMBER: 300601652
	VISIT DATE: 08/17/2023

NARRATIVE

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Following was observed in all the rooms:
Age appropriate furniture and activities including educational, arts & crafts items.
Rooms are well ventilated with proper lighting and shade.
There is a working Smoke detector. Carbon Monoxide detector at the facility.

The measurement of the rooms according to updated numbers are as below:
Room 1 is: 589.60 square feet
Room 6 is: 634.94 square feet
Room 7 is: 524.68 square feet
Room 10 is: 628.67 square feet
Room 12 is: 634.94 square feet
Room 15 is: 308.96 square feet
Total indoor measurement for the rooms are 2995.91 square feet divided by 35 square feet =85.60
(86 children).

Toilets: 6 X 15= 90 children
Sinks: 6 X 15 = 90 children.
There are 4 toilets and 2 sinks in one bathroom in the hallway and there are 2 toilets, 2 sinks, and 2 urinals in the other bathroom in the hallway. There are 2 sinks in room 7.

Outdoor Activity Space:
Total measurement of the outdoor space is: 8480.73 square feet divided by 75 square feet= 113.08 (113 children).
Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment with adequate of cushioning materials under the climbing structure, and slides. Shade is provided by trees, awning, and building structure.

LPA reviewed with director the LIC 311A, Records to Be Maintained At The Facility, for child’s records,

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH DAVID PRE SCHOOL	FACILITY NUMBER: 300601652
	VISIT DATE: 08/17/2023

NARRATIVE

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personnel records, administrative records, and documents to be posted. The director's Health and Safety Training is current. Her CPR and 1st aid is current, EMSA approved and expires 1/2025

The director, Nicole Wilson 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 provides 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.

Licensee 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.

Continued on page 4

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: TEMPLE BETH DAVID PRE SCHOOL	FACILITY NUMBER: 300601652
	VISIT DATE: 08/17/2023

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Exit interview conducted and report was reviewed with the director, Nicole Wilson.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Based on today’s measurements, the sinks and toilets availability, the request of the facility for increasing capacity from 63 to 73 preschool children in rooms 1, 6, 7, 10, 12, and 15 will be final reviewed and discussed with management in the Regional Office and after receiving the following corrections. The facility will be notified if any additional information is required. Please send the following corrections within 30 days of today's date.

Fire clearance approval has been received in our office to approve the capacity of 73 children. However room 7 has been approved for children above 36 months of age.

1- The diaper changing table in room 1 does not meet the licensing regulations. The changing table shall be within the arm's reach of a sink. The director will send her plan to correct this situation.
2- Securing one shelf in room 7
3- Securing tall white shelf in room 10
4- Securing doll house, book shelf, tall shelf, and children's items such as refrigerator, and sink in dramatic area in room 12
5- Securing tall book shelf, regular book shelf, and 5 items of children's items in dramatic area in room 15.
6- Tdap vaccine for staff # 1
7- Mandated Reporter Training Certificate for staff # 1 which does not meet licensing requirement.

End of report.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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