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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371224
Report Date: 06/01/2021
Date Signed: 06/01/2021 04:18:10 PM

Document Has Been Signed on 06/01/2021 04:18 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:KIDDIE ACADEMY OF SANTA ANAFACILITY NUMBER:
304371224
ADMINISTRATOR:SOLORIO, ALANNAHFACILITY TYPE:
850
ADDRESS:1345 NORTH GRAND AVENUETELEPHONE:
(714) 599-1783
CITY:SANTA ANASTATE: CAZIP CODE:
92701
CAPACITY: 92TOTAL ENROLLED CHILDREN: 0CENSUS: 53DATE:
06/01/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Alannah SolorioTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Hawkins conducted an onsite inspection for the purpose of an Annual Random. LPA and director toured the facility inside and outside and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 9 preschool staff and 53 preschool children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. 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 prepared on site; breakfast, lunch and snacks are provided. Food prep areas were clean and sanitary. Food is properly stored. Menus were posted where they could be reviewed by parents. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. There is drinking water available to children indoors by drinking fountain and 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. The facility has conducted an emergency drill within the past six months. The facility has a working carbon monoxide detector and fire extinguisher. Facility met all posting requirements. The California Child Passenger Safety Law was posted by the entrance of the facility.

Staff files were reviewed for staff present during the facility inspection this date. 9 staff files were reviewed. Health screening, immunizations, and mandated reporter training 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.
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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2021
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF SANTA ANA
FACILITY NUMBER: 304371224
VISIT DATE: 06/01/2021
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***page 2***
Proof of immunization against pertussis, measles for staff 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 8/1/22.

The director was informed that the Criminal Record Statement (LIC 508) has been
updated, and the facility must now use the new form with revised date 7/15. Director was also informed that the LIC 508 must be submitted with all Criminal Background Clearance.

Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of 10 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/immunizations. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The facility uses an electronic sign in/out procedure with personal codes identifying the person and records the time of day.

This facility provides Incidental Medical Services - (IMS). Director states there are no children currently enrolled that requires IMS services. LPA reviewed storage of where medication/equipment is stored. 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

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 cushioning material rubber mats commercially produced for the purpose around the climbing equipment, slides and other similar equipment appeared to be enough to absorbs falls.
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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF SANTA ANA
FACILITY NUMBER: 304371224
VISIT DATE: 06/01/2021
NARRATIVE
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***page 3***
Drinking water in the outdoor activity space is provided by drinking fountain which appeared to be unsanitary as evidenced by dirt observed on fountain and drinking spout which posses an immediate risk to the health and safety of children in care. 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.

Inspection and report reviewed and exit interview was conducted in English with Director.
Transfer Request (LIC9182). The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov

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 link 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
(IF SPANISH) Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
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

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF SANTA ANA
FACILITY NUMBER: 304371224
VISIT DATE: 06/01/2021
NARRATIVE
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· 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

Updated face covering guidance was provided and director was to continue to message the “Three W’s”: Wash your hands. Watch your physical distance. Wear a mask. This face covering guidance is for all individuals 2 years and older, except for the exceptions (child’s development, medical exemptions, etc.) that are outlined by CDPH.
Important COVID-19 resources and links were provided:
· CDC Student become sick diagnosis flowchart· CDC Example of Routine Childcare disinfecting

· CDC Stop the Spread of Germs poster


· COVID-19 General Guidance Cleaning/Disinfecting in Childcare facilities:
· COVID-19 Update Guidance Childcare Programs/Providers link:

https://files.covid19.ca.gov/pdf/guidance-childcare.pdf


· CCLD COVID-19 Licensed childcare and facilities and provider FAQs link: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources/faqs-for-licensed-child-care-facilities-and-providers

Safe, free, and effective COVID-19 vaccines are now available to everyone age 16 and up. Every Californian can sign up at myturn.ca.gov or call (833) 422-4255 to get their COVID-19 vaccine appointment.

Based on LPAs observations the following violation was observed is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 3, Section 101239, is being cited on the attached LIC 809D. *** continued on page 5***

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF SANTA ANA
FACILITY NUMBER: 304371224
VISIT DATE: 06/01/2021
NARRATIVE
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***page 5***

An 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. If the facility receives a Type A violations, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00

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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/01/2021 04:18 PM - It Cannot Be Edited


Created By: Sherene Hawkins On 06/01/2021 at 03:14 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: KIDDIE ACADEMY OF SANTA ANA
FACILITY NUMBER: 304371224

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/02/2021
Section Cited
CCR
101239.2(a)

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101239.2 Drinking Water (a) Drinking water from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area. This requirement was not met as evidenced by the drinking fountain in the outdoor activity space
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Director will provide drinking water in a water pitcher/cups daily for the children. Director will have the outdoor water fountain disconnected/closed off. Director will provide pictures email of the corrections by POC due date.
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appeared to be unsanitary as evidenced by dirt observed on fountain and drinking spout which poses an immediate risk to the health and safety of children in care.
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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:Judy Hanson
LICENSING EVALUATOR NAME:Sherene Hawkins
LICENSING EVALUATOR SIGNATURE:
DATE: 06/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/01/2021


LIC809 (FAS) - (06/04)
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