300605642-1-25-2023-06-CC-MMAK-CNEVZV-20230125155321

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300605642
Report Date: 01/25/2023
Date Signed: 01/25/2023 03:53:28 PM

Document Has Been Signed on 01/25/2023 03:53 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:	LUTHERAN CHURCH OF THE CROSS		FACILITY NUMBER:	300605642
ADMINISTRATOR:	LUNDBOHN, JOAN		FACILITY TYPE:	850
ADDRESS:	24231 EL TORO ROAD		TELEPHONE:	(949) 581-8115
CITY:	LAGUNA WOODS	STATE: CA	ZIP CODE:	92637
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 21	DATE:	01/25/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Director		TIME COMPLETED:	04:15 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 conducted an announced Case Management Licensee initiated inspection at the above facility for the purpose of increasing the preschool capacity from 48 children to 60 children by adding one new room (Room E or Church Nursery Room) to the existing rooms. LPA met with director, Joan Lundbohn who gave LPA a tour of the facility. LPA observed 21 resting preschool age children with two staff members, providing care and supervision to the children in Rooms A, B, C, and D. Rooms A and B and rooms C and D are connected and can be separated by an existing patrician. Currently facility is licensed for 48 preschool children, ages 2 years to 6 years old in four assigned rooms A, B, C, and D. The facility has added Room E to the existing rooms increasing their total preschool capacity to 60 children. The following was observed in the classrooms: · Age appropriate furniture and equipment. · Educational items /Arts and Crafts activities. · Rooms are well lighted with ventilation. · Drinking water is available through filtered water dispensers placed in each classrooms and personal water bottles Facility offers AM/ PM snacks to the preschool age children. Lunch is brought from home and stored in the individual cubbies. Children nap on mats, linens and blankets are brought from home and washed weekly at home. · CDC Guidelines are being followed. · Classrooms has specific age appropriate bathrooms. Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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: LUTHERAN CHURCH OF THE CROSS	FACILITY NUMBER: 300605642
	VISIT DATE: 01/25/2023

NARRATIVE

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For Incidental Medical Services- 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)/ (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

Review of records to be maintained : LPA reviewed with Facility Representative Joan Lundbohn, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Subscribe to CCLD important information

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 platform.

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.

Notice of Site Visit : 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.

Exit Interview :Exit interview conducted and report was reviewed with the Facility Representative, Joan Lundbohn

An updated license will be issued for 56 children ages 2 to 6 years old, Monday to Friday from 7:30 am to 5:30 pm in rooms A, B, C, D, and E after receiving the following correction, final file review and management approval.

1- Securing the tall doll house in the new room (Room E).
End of reports.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

Page: 4 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: LUTHERAN CHURCH OF THE CROSS	FACILITY NUMBER: 300605642
	VISIT DATE: 01/25/2023

NARRATIVE

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On today’s inspection classrooms A, B, C, D, and the new classroom E were measured.

Indoor activity space:
The total activity space for rooms A, B, C, D, and E are: 2516 square feet divided by 35= 71.89 (72 children) (Facility has sufficient space to accommodate 60 preschool age children in the five assigned rooms)

Total sinks: 7 X 15 = 105 children
Total toilets: 4 X 15= 90(children)
Facility has sufficient sinks and toilets to support the requested capacity of 60 preschool age children.

Outdoor space: Facility has a designated Preschool age yard, which is at the side of the building. There are 2 sinks on this playground included in the total number of sinks in the facility.
Preschool age yard has a surrounding fence with soft cushion flooring, placed on the age appropriate toy structures with shade to absorb any falls and shade is provided by a building structure and a shaded canopy. Age appropriate toys and play structures were observed in the yard. There is also a side yard attached to the playground in front of the classroom doors that can be used for children's art and activities. There is a small patio in front of the new added room (E) which was measured 504 square feet enough for 7 children which is all fenced. This classroom might use this area for activities and other projects.

Outside measurements: Total playground and side yard is 4237 square feet divided by 75 = 56.49
(56 children).

Based on the indoor measurements, outdoor measurements, number of toilets, and sinks, the total capacity will be 56 children. LPA discussed the process of waiver request for playground on staggered scheduling, the director agreed to be licensed for 56 children without any waiver request.

Continued on page 3

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

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: LUTHERAN CHURCH OF THE CROSS	FACILITY NUMBER: 300605642
	VISIT DATE: 01/25/2023

NARRATIVE

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After a tour of the center, no deficiency was observed.

Facility Administrator is current on the required Pediatric CPR/First Training and Mandated Reporter Training.

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian Facility has access to the Guardian system.

Fire clearance has been granted by Orange County Fire Authority for the requested capacity of 60 children. Criminal Record Statement : Facility Representative (Joan Lundbohn) 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Safe Sleep LPA discussed the safe sleep regulations with Facility Representative (Joan Lundbohn ) discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Continued on page 4

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023

LIC809 (FAS) - (06/04)

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