300614011-4-17-2023-06-CC-MMAK-CQYU56-20230417151612

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300614011
Report Date: 04/17/2023
Date Signed: 04/17/2023 03:16:20 PM

Document Has Been Signed on 04/17/2023 03:16 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:	ANAHEIM ELEMENTARY SCHOOL DISTRICT EDISON		FACILITY NUMBER:	300614011
ADMINISTRATOR:	PADILLA KATHY		FACILITY TYPE:	850
ADDRESS:	1526 EAST ROMNEYA		TELEPHONE:	(714) 517-8760
CITY:	ANAHEIM,	STATE: CA	ZIP CODE:	92805
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 41	DATE:	04/17/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:31 PM
MET WITH:	Site supervisor		TIME COMPLETED:	03:45 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 2 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of changing room. The facility has requested to remodel Room A and C with moving the children to Room B one at a time (24 children in each room). This move will be temporarily and children will be back to Room A and B after it is remodeled. The Preschool closes on June 8 and reopens August 9, 2023 for the new academic year. LPA met with site supervisor, Kathy Padilla Flores. LPA also met with Lynda Durand, School Readiness Coordinator from Office of Early Childhood Education with Anaheim Elementary School District who toured the facility with LPA. Census was taken. Currently the facility is licensed for 48 children in rooms A, and C. LPA observed 41 children with 6 staff in two rooms including Site Supervisor. According to Linda Durand Room A and C will move to Room B individually with 24 children only until each room is ready. 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 staff are employees of Anaheim Elementary School District) The State Preschool is a Title 5 Program that offers two morning and afternoon sessions. The facility provides morning snack and afternoon lunch to children. Children do not nap in this program. The children are dropped off and are singed in and out at the entrance door. The facility has met all the posting requirements. The indoor activity space measurement for the current Room B to move with 24 children one at a time is as follows: PSB # : 836 square feet divided by 75 = 23.88 (24 children). Total outdoor activity space measurement is as follows: Outdoor space in front of the classrooms: 9913 square feet divided 75 sq feet = 132.17 (132 children). Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

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: ANAHEIM ELEMENTARY SCHOOL DISTRICT EDISON	FACILITY NUMBER: 300614011
	VISIT DATE: 04/17/2023

NARRATIVE

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There are two sinks in Room B. There is no toilet in this room. The preschool has a waiver in place to use additional restroom that is close to the classrooms. There are two toilets and two sinks in each girl's and boy's restrooms. Room A and C have one toilet in them. There are two sinks in each room too.
The preschool is sharing the playground with TK and Special Ed Program.
The classroom is equipped with carbon monoxide detector.
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)/ (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

Orange county Fire authority has approved Room PSD for re-locating children one at a time.
Based on today’s measurement, the sinks and toilets availability, the request of the facility for moving 24 children at a time to Room C for remodelling will be discussed with management in the Regional Office. The facility will be notified if any additional information is required.

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. 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 conducted and report was reviewed with the applicant on file, Lynda Durand.

Per Fire Department's instruction, temporary room change form PSC to PSB, and temporary room change from PSA to PSB will not occur concurrently. Linda Durnad is aware that moving of children from Room PSA and PSC to Room PCB will be 24 children at a time during remodeling of their classroom. Children will go back to their own rooms of PSA and PSC when remodeling is done.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2