304370878-6-5-2024-06-CC-SGAA-D5XV2V-20240605160346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304370878
Report Date: 06/05/2024
Date Signed: 06/05/2024 04:03:55 PM

Document Has Been Signed on 06/05/2024 04:03 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:	CALVARY BAPTIST CHURCH-IKIDS PRESCHOOL		FACILITY NUMBER:	304370878
ADMINISTRATOR/ DIRECTOR:	RENEE DURAN		FACILITY TYPE:	850
ADDRESS:	612 NORTH ROSE DRIVE		TELEPHONE:	(714) 961-5437
CITY:	PLACENTIA	STATE: CA	ZIP CODE:	92870
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 90	CENSUS: 52	DATE:	06/05/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:10 AM
MET WITH:	Renee Duran, Director		TIME VISIT/ INSPECTION COMPLETED:	04:35 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	Licensing Program Analyst (LPA), Sarah Garcia conducted an onsite inspection for the purpose of an Annual Random. LPA and assistant director, Cindy Gough conducted a walk-through of the facility inside and outside and the floor and yard plan were verified. At 10:00am, LPA met with Renee Duran, Director. Census was taken in individual classrooms. The overall census observed was 52 preschool children and 6 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7a.m.- 6:00p.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. 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 provided by parents. Food is properly stored in children's cubbies. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. LPA inspected the children's bathroom and observed a solid waste bin without a tightfitting lid. LPA discussed the importance of tight fitting lids on solid waste to prevent contamination. LPA issued a Type B citation. There is drinking water available to children indoors by sports bottle with the child’s name on it. The children's bathrooms are clean and sanitary. Children nap on cots, and bedding is stored individually and is taken home weekly to be washed by parents or facility washes bedding at end of week. The facility has not conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector and fire extinguisher 2A10BC. Facility met all posting requirement. The California Child Passenger Safety Law was posted by the entrance of the facility. Page 1

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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: CALVARY BAPTIST CHURCH-IKIDS PRESCHOOL	FACILITY NUMBER: 304370878
	VISIT DATE: 06/05/2024

NARRATIVE

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Staff files were reviewed for staff present during the facility inspection on this date, 4 out of 4 staff files were reviewed. Health screening and immunizations 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 family day care home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for (licensee and assistant) were reviewed and within 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. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of (4) of 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. The person who signs the child in and out uses their full legal signature and records the time of the day.

LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. LPA observed 3 expired medications. Director will return expired medication to children's parents. LPA will issue a Type B Citation. 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

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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: CALVARY BAPTIST CHURCH-IKIDS PRESCHOOL	FACILITY NUMBER: 304370878
	VISIT DATE: 06/05/2024

NARRATIVE

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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. LPA observed the cushioning material, sand around the climbing equipment, slides and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by sports bottles with the child’s name on it. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair.

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov and may request to be added to an email list to receive a Quarterly Update. The Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The director was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the facility representative.

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the director.
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

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: CALVARY BAPTIST CHURCH-IKIDS PRESCHOOL	FACILITY NUMBER: 304370878
	VISIT DATE: 06/05/2024

NARRATIVE

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NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Based on California Code of Regulations, Title 22, Division 12, Chapter 3, (2) deficiencies will be cited today.

An Inspection and exit interview was completed with director. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative 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: Patricia Magana
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/05/2024 04:03 PM - It Cannot Be Edited

Created By: Sarah Garcia On 06/05/2024 at 03:33 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: CALVARY BAPTIST CHURCH-IKIDS PRESCHOOL	FACILITY NUMBER: 304370878
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/05/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101226(e)

Health-Related Services

(e) In centers where the licensee chooses to handle medications: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in 3 out of 3 medications were expired which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/05/2024
	Plan of Correction
1 2 3 4	Director will return the 3 expired medications to the children's parent or authorized representative by 06/05/2024.

Type B

Section Cited

CCR

101239(f)(1)

Fixtures, Furniture, Equipment and Supplies

(f) Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in the solid waste bin did not have a tightfitting lid and was not in good repair which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/05/2024
	Plan of Correction
1 2 3 4	On 06/5/24 Director replaced the solid waste bin. LPA inspected the solid waste bin and observed a tightfitting lid in good repair.

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:

Patricia Magana

LICENSING EVALUATOR NAME:

Sarah Garcia

LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024

LIC809 (FAS) - (06/04)

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