304370444-6-8-2023-06-CC-MMAK-CSM3U6-20230608183302

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370444
Report Date: 06/08/2023
Date Signed: 06/08/2023 06:33:51 PM

Document Has Been Signed on 06/08/2023 06:33 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:	OC KIDS CHILDCARE INC.- CAWTHON		FACILITY NUMBER:	304370444
ADMINISTRATOR:	DIAZ, AMY		FACILITY TYPE:	850
ADDRESS:	10160 DENNI STREET		TELEPHONE:	(714) 484-7844
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY: 71	TOTAL ENROLLED CHILDREN: 71	CENSUS: 30	DATE:	06/08/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Licensees		TIME COMPLETED:	02:00 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 decreasing capacity of the preschool program by taking off one of the classroom (Classroom A converting to infant room). LPA met with licensees, Casie Hollenbeck, Karissa Degener, and director, Amy Diaz who gave a tour of the school to LPA. Currently the facility is licensed for 71 preschool children in rooms # A, B, and C. LPA observed there were 4 staff with 30 children on the preschool playground. The facility is located on a School District Site. Currently the school is not in operation for public elementary school children. 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 has requested to provide care and supervision to 47 preschool children ages 2 to 6 years old in rooms B, and C, Monday to Friday from 6:00 am to 6:00 pm. The facility runs a full time and part time program. Children are dropped off, signed in and out manually at the entrance of the building to go to assigned rooms. The facility has met all the posting requirements. All the classrooms were measured. The indoor activity space measurement for the current requested capacity is as follows: Room B is: 812.76 square feet Room C is:809.83 square feet Total indoor measurement for both rooms are: 1647.64 divided by 35 = 47.08 (47 children). Total outdoor activity space measurement is as follows: Outdoor space for the preschool playground 11520 square feet divided by 75 =153.60 (154 children). Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: OC KIDS CHILDCARE INC.- CAWTHON	FACILITY NUMBER: 304370444
	VISIT DATE: 06/08/2023

NARRATIVE

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There are adequate cushioning materials (sand) under and around the climbing structure and slide. Shade is provided by large tree.
Total of toilets: 2 X 15 = 30 children inside the classrooms.
Total of sinks: 2 X 15 = 30 children inside the classrooms.
There are 5 toilets and 3 sinks in the Girl's bathroom on the school ground that the facility will request a waiver to share with children of Grace Christian School on this campus.
The facility representative stated the carbon monoxide detector and smoke detector are combined in one device and was installed in the ceiling. All the classrooms have age appropriate toys and equipment.
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 the facility for 47 preschool children in two rooms of B, and C with the restriction of Room B maximum of 23 children and Room C maximum of 24 children. 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 representatives. Based on today’s indoor and outdoor measurements, the sinks and toilets availability, the request of the facility for 47 preschool children in rooms B, and C with the restriction of Room B maximum of 23 children and Room C maximum of 24 children will be final reviewed and discussed with management in the Regional Office and after receiving the following. The facility will be notified if any additional information is required. Please submit the following no later than 30 days of today's date.

1- waiver request for sharing additional restrooms and sinks on the premises for the capacity of 47 children. For waiver, please send a request letter, LIC 999, LIC 500, and a photo of the sharing restroom.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023

LIC809 (FAS) - (06/04)

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