304270968-10-8-2024-06-CC-AFCN-D9UT5M-20241008142547

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270968
Report Date: 10/08/2024
Date Signed: 10/08/2024 02:25:56 PM

Document Has Been Signed on 10/08/2024 02:25 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KATHERINE IRVINE DAY SCHOOL		FACILITY NUMBER:	304270968
ADMINISTRATOR/ DIRECTOR:	ROSA DOMINGUEZ		FACILITY TYPE:	830
ADDRESS:	1002 WEST 2ND STREET		TELEPHONE:	(714) 541-8164
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92701
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 16	CENSUS: 13	DATE:	10/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:40 PM
MET WITH:	Director Rosa Dominguez		TIME VISIT/ INSPECTION COMPLETED:	02:40 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	On 10/08/24, Licensing Program Analyst (LPA), Anna Chan conducted an unannounced onsite inspection for the purpose of an Annual Random Visit. LPA met with Director Rosa Dominguez and toured the facility inside and outside and the floor and yard plan were verified. Census was taken in individual classrooms. The overall census observed was 13 infant children and 4 staff. Children were napping when LPA arrived around 12:40pm. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:30a.m.- 5:30p.m., Monday through Friday. 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. All staff is fingerprint associated through a master file under Matt Kline Headstart (300603968). During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Food is being delivered by American Lunches. Menus are posted where it can be seen by parents in the classrooms. Allergy list of children are also placed in a cupboard in each classroom. Water is provided by a filtered water from the sink and sippy cups and sports bottles with children’s name on it. Page 1 of 3

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KATHERINE IRVINE DAY SCHOOL	FACILITY NUMBER: 304270968
	VISIT DATE: 10/08/2024

NARRATIVE

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Children nap on cots and some nap on cribs. Beddings are stored individually. Sheets and blankets are washed by the facility daily. The facility conducted an emergency drill on 09/25/24. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility.

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. The playground has a rubberized surfacing around the climbing structure which appears to be enough to absorb falls. Drinking water in the outdoor activity space is provided by purified water and sports bottles and sippy cups with the children’s name on it. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water at the premises.

5 Staff files were reviewed for the facility inspection on this date. Health screening and immunization as required were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1596.7995 (a)(1) 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.
Proof of immunization against pertussis, measles for the facility were reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporter training, and to renew the training every two years. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 11/2024.

5 Children's records were reviewed, and there was a separate, complete, and current record for each child. Sign in/out procedure in Learning Genie was reviewed, parents have their own login ID. In the areas reviewed the children’s files were found to be in full compliance.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KATHERINE IRVINE DAY SCHOOL	FACILITY NUMBER: 304270968
	VISIT DATE: 10/08/2024

NARRATIVE

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Currently, there are medications in the facility. This facility provides Incidental Medical Services (IMS) LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

LPAs discussed the safe sleep regulations with facility representative and 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. LPAs also informed 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.

In the areas that were evaluated, there is no deficiency observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

An Inspection and exit interview were completed with Director Rosa Dominguez. The report was reviewed and discussed. Appeal Rights were discussed. The director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

LIC809 (FAS) - (06/04)

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