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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371288
Report Date: 10/27/2021
Date Signed: 10/27/2021 11:15:20 AM

Document Has Been Signed on 10/27/2021 11:15 AM - 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:GGUSD-SKYLARK PRESCHOOLFACILITY NUMBER:
304371288
ADMINISTRATOR:DEVEREUX, CAMILLAFACILITY TYPE:
850
ADDRESS:11250 MACMURRAY STREETTELEPHONE:
(714) 663-6336
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 80DATE:
10/27/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Principal Camilla DevereuxTIME COMPLETED:
11:35 AM
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A case management inspection was conducted on this day by Licensing Program Manager (LPM) Ho and Licensing Program Analyst (LPA) Nguyen. LPM and LPA observed 80 preschool children with 15 staff members during today's inspection. The purpose for today's inspection was to measure and inspect the new rooms. Facility is currently licensed for 144 preschool children in room D1, D2, C11, C12, C13, and B24 and seeking to change to room D1, D2, I31, I32, I33, H41, H42, H43, G53 and Multipurpose Room (MPR). LPM and LPA toured the entire facility indoors & outdoors and the following measurements were taken:

Indoor:
Room D1 and D2 have the same measurements of 39'6" x 32'9" = 1293' divided by 35' = 36 children for each room (previous measurement on 8/26/2019).
Room I31, I32, I33 have the same measurement of 28'6" x 28'3" = 805' divided by 35' = 23 children for each room.
Room H41, H42, H43 have the same measurement of 28'9 x 28' = 805' divided by 35' = 23 children for each room.
Room G53: 29' x 28' = 812' divided by 35' = 23 children.
Multipurpose Room: 46' x 47' = 2162' divided 35' = 61 children.

Total indoor = 294 children in the following rooms: D1, D2, I31, I32, I33, H41, H42, H43, G53 and (MPR).
Total children toilets and sinks:
13 toilets x 15 = 195 children
17 sinks x 15 = 255 children
Outdoor (previously measured on 8/26/2019):
State Preschool Yard (Behind build D): 131'6 x 46' = 6081'/75' = 81 children
Fee Based Program Yard (Behind build B & C): 180' x 195' = 35,100'
107' x 75' = 8025'
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2021
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GGUSD-SKYLARK PRESCHOOL
FACILITY NUMBER: 304371288
VISIT DATE: 10/27/2021
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Total yard for Fee Based Program: 35,100' + 8025' = 43125' divided by 75' = 575 children.

Room D1 and D2 are used for the State Preschool. The other remaining rooms will be used for the Fee Based Program.

Fire clearance from Orange County Fire Authority has been received and approved for requested capacity for room D1, D2, I31, I32, I33, H41, H42, H43, G53 and (MPR).

Based on today's inspection, rooms D1, D2, I31, I32, I33, H41, H42, H43, G53 and (MPR) are approved to serve 144 preschool children..

The following was observed:
· Classrooms were adequately equipped with age and size appropriate furniture and equipment
· Water fountains were available for inside drink and bottle fillers were available for outside drink.
· Playground is enclosed by appropriate fence.
· Outdoor activity area is supplied with age and size appropriate equipment
· Adequate shade is provided by trees.
· The health office will temporarily serve as the isolation area for ill children until parents arrive.
· There's a bathroom in the health office and it's used as the isolation bathroom for ill children.
· Medications are being stored in the health office and is inaccessible to children.

No deficiency was observed during today's inspection.

Exit interview was conducted and a copy of this report was provided to the principal on this date.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021
LIC809 (FAS) - (06/04)
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