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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270768
Report Date: 02/26/2024
Date Signed: 02/26/2024 02:57:53 PM

Document Has Been Signed on 02/26/2024 02:57 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:EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACHFACILITY NUMBER:
304270768
ADMINISTRATOR:NAVARRETE, JONATHANFACILITY TYPE:
850
ADDRESS:1085 LAGUNA CANYON ROADTELEPHONE:
(949) 494-2535
CITY:LAGUNA BEACHSTATE: CAZIP CODE:
92651
CAPACITY: 50TOTAL ENROLLED CHILDREN: 39CENSUS: 18DATE:
02/26/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:DirectorTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite inspection for the purpose of Required -3 year inspection. LPA met with director, Jonathan Navarrette who gave LPA a tour of the facility inside and outside. The floor and yard plan (LIC 999) were checked. LPA took census, there were a total of 18 napping preschool children with one staff in room # 2. The other staff was at lunch break. There were no children present in room # 1. According to director, school bus will drop off the kindergarten children around 2:45 pm for this room. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 8:00 a.m.- 3:30 p.m., Monday through Friday.

Parents sign their children in and out electronically. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Both classrooms were inspected. During the inspection of the indoor activity space, items which could pose a danger to children (cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Facility provides breakfast and lunch and snack is provided by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. Drinking water is available to children indoors by water containers that children bring from home and the facility fill them up with filtered water.

Children nap on mats, and bedding is stored individually and washed on a daily basis by the facility. The facility has conducted an emergency drill within the past six months, last drill was in 2/6/2024.
The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACH
FACILITY NUMBER: 304270768
VISIT DATE: 02/26/2024
NARRATIVE
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There are two outdoor activity spaces for children. One playground opens from room # 1 and was enclosed by a fence at least four feet in height. The surface of the outdoor activity space (concrete) was well maintained and free of hazards. There were no climbing structure, swings, and slides on this playground for children. The other preschool yard has a surrounding fence with age appropriate climbing structures placed on the soft cushioned materials to absorb falls. Drinking water in the outdoor activity space is provided by water containers children brought from home and the facility fills them up by filtered water if needed. The outdoor equipment and toys were in good repair and free of sharp edges. Shade is provided. There are no bodies of water present at the facility.

Staff files were reviewed for staff present during the facility inspection on this date, 3 staff files were reviewed. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a childcare center if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for staff were reviewed.(not in compliance). Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. (not in compliance). At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which all were in compliance.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 5 children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance.
Sign in/out procedure was reviewed for compliance.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024
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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: EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACH
FACILITY NUMBER: 304270768
VISIT DATE: 02/26/2024
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For child care center licenses issued after July 1, 2022, the licensee shall test their water for
lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-
CCP). LPA verified that the lead testing was not completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP. LPA referred the director, Jonathan Navarrette to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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


LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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 are available at:https://www.ada.gov/resources/child-carecenters

The facility representative, Jonathan Navarrette 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.

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 communications.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024
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: EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACH
FACILITY NUMBER: 304270768
VISIT DATE: 02/26/2024
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The facility representative, Jonathan Navarrette 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.

To improve the quality and value of the new inspection process, a survey may be sent to the


email address provided. Please complete the survey and share your inspection experience. If
you have any questions regarding the process or CARE tools, please send email inquiries to
inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its
tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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

In the areas that were evaluated, The following deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at this inspection date. Please refer to LIC 809D.


Exit interview conducted and report was reviewed with the facility representative, Jonathan Navarrette

End of report.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/26/2024 02:57 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 02/26/2024 at 02:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACH
FACILITY NUMBER: 304270768

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above by not testing their water for lead as it was required which poses a potential health, safety risk to persons in care.
POC Due Date: 03/26/2024
Plan of Correction
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The director agreed to have the water tested according to Provided Information Notices (PIN) directives. The director will send the process update the to completion of the testing with results to LPA's email address.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 counts out of 3 files that missing Mandadter Reporter Training Certificates for staff # 2 and staff # 3 which poses a potential health, safety risk to persons in care.
POC Due Date: 03/26/2024
Plan of Correction
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The director agreed to send the completed certificates to LPA's email address by the due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 02/26/2024 02:57 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 02/26/2024 at 02:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVEN START, BOYS AND GIRLS CLUB OF LAGUNA BEACH
FACILITY NUMBER: 304270768

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 counts out of 3 files that missing required vaccinations for staff # 2 and staff # 3 which poses a potential health, safety risk to persons in care. Staff # 2 missing MMR and Dtap. Staff # 1 missing Dtap vaccines.
POC Due Date: 03/26/2024
Plan of Correction
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The director agreed to send the completed certificates to LPA's email address by the due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2024


LIC809 (FAS) - (06/04)
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