304371023-8-15-2023-06-CC-MMAK-CUQUKQ-20230815153930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371023
Report Date: 08/15/2023
Date Signed: 08/15/2023 03:39:38 PM

Document Has Been Signed on 08/15/2023 03:39 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:	CAROUSEL PRESCHOOL AND DAYCARE CENTER		FACILITY NUMBER:	304371023
ADMINISTRATOR:	TROCH, TRACIE		FACILITY TYPE:	840
ADDRESS:	5890 CATHY AVENUE		TELEPHONE:	(714) 828-7430
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY: 80	TOTAL ENROLLED CHILDREN: 80	CENSUS: 0	DATE:	08/15/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Director		TIME COMPLETED:	04:15 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 4 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of the facility increasing their capacity from 80 school age children to 120 school age children by adding room # 3. Room # 3 is designated for preschool children in the morning from 7:00 am to 12:00 pm. Room # 3 will be for the usage of school age children from 1:20 pm to 6:00 pm. Monday to Friday. Currently the facility has been licensed for 80 children in rooms 1 and 2. Room # 2 is also used for preschool children in the morning from 7:00 am to 12:00pm. LPA met with the director, Traci Troch who gave LPA a tour of the facility. The facility is located on the ground of Frank Vessels Elementary school Site of Cypress Unified School District. There were no children present on this inspection date. 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 not employees of the Unified School District). The facility provides morning and afternoon snacks to children. The children are signed in from the elementary school by staff electronically and parents signed them out electronically. The facility has met all the posting requirements. If children become ill during the day, they will rest in the isolation area located in the corner of the room away from the other children, and use the adult restroom. Following was observed in the rooms: Age appropriate furniture and activities including Educational, arts & crafts items. Room is well ventilated with proper lighting and shade. There is a working Smoke detector and Carbon Monoxide. Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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: CAROUSEL PRESCHOOL AND DAYCARE CENTER	FACILITY NUMBER: 304371023
	VISIT DATE: 08/15/2023

NARRATIVE

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Outdoor Activity Space: Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment with adequate of cushioning materials under the climbing structure, and slides. Shade is provided by building structure and trees.
Fire clearance approval has been received approving the requested capacity of 120 children.
This school age childcare program meets the requirements of Health and Safety Code Section 1596.806 and is exempt from square footage requirements for indoor, and outdoor activity space. The facility is also is exempt from fencing, outdoor activity space, toilet, and isolation space requirements. The capacity per room for a school age childcare program that meets the requirements of Health and Safety Code Section 1596.806 shall not exceed the number of children for which a room of this size is commonly approved for school use during the school day. According to a letter from the assistant superintendent, Tim McLellan each room can accommodate the number of children requested on the application for each room. Each room for 40 school age children. Rooms 1, 2, and 3 are designated for the school age use.
§1596.806: Exemption from square footage, toilet, isolation space, outdoor activity space, and fencing requirements
(a) A room used as a classroom by a school-age childcare program shall not be required to meet the square footage or toilet requirements for child day-care centers if the program is operated on either of the following:
(1) A functioning school site in the same facilities that have housed school children during the day, before or after school hours, or before and after school hours.
(2) A functioning school site in facilities certified as usable as a classroom for instruction. A building owned by a school district, the state, or the school age child care program may meet the certification requirement if either of the following is provided to the department:
(A) Evidence that the building was approved as a classroom by the Division of the State Architect.
(B) A certification statement signed by the superintendent of the schools, or their designee, in the district where the school age childcare program is located, that the classroom building is of sufficient size to accommodate public instruction. The school district may make this certification regardless of the ownership of the classroom.
(b) School grounds, other than rooms used as classrooms, used by a school-age childcare program
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: CAROUSEL PRESCHOOL AND DAYCARE CENTER	FACILITY NUMBER: 304371023
	VISIT DATE: 08/15/2023

NARRATIVE

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operated on a functioning school site pursuant to either paragraph (1) or (2) of subdivision (a) shall be exempt from all of the following requirements imposed by the department on child day-care facilities:.

Requirements to have exclusive use of the outdoor activity space or exclusive use of children’s rest rooms
also used by students located on school grounds.
(c) The exemptions pursuant to subdivisions (a) and (b) shall continue during school vacation and intercession periods.
(d) (1) For purposes of this section, “school-age childcare program” means a program for children who are currently enrolled in a school, including transitional kindergarten, as defined in Section 48000 of the Education Code, or are dependent children living within the same household as a child attending a school, operated by an entity that contracts with the school to provide staff and program.
(2) Notwithstanding the rule making provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the department may implement and administer the changes made by the act that added this paragraph through letters or similar written instructions that shall have the same force and effect as regulations until regulations are adopted.
Total of sinks: 11 X 15 = 165 children
Total of toilets: 2 X 15 = 165 children
Urinals: 4 X 5 = 20 children
There are 3 toilets, 2 urinals, 4 sinks in the boys bathroom and there are 6 toilets, and 3 sinks in the girls bathroom. There is one sink in room # 1, 2 toilets and 2 sinks in room # 2, and 2 sinks and one toilet in room # 3
The facility has access to all the restrooms on the campus because elementary children are not present during the operation of school age program.

This facility plans to provide 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) or (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: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CAROUSEL PRESCHOOL AND DAYCARE CENTER	FACILITY NUMBER: 304371023
	VISIT DATE: 08/15/2023

NARRATIVE

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LPA reviewed with applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. The director is current on CPR and 1st aide, immunization, and Mandated Reporter Training.

The Director, Traci Troch 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee 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.

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 communication.

Exit interview conducted and report was reviewed with the director, Traci Troch.

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.

The request of the facility to add room 3 with a capacity of 120 children in rooms 1, 2, and 3 will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required.Rooms 2 and 3 will be used for preschool children from 7:00 am to 12:30 pm. School age program will use the rooms 1, 2, and 3 from 1:20 to 6:00 pm during public school days. Room 1 and 2 for non school days to maximum of 80 children only.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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