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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371294
Report Date: 08/12/2021
Date Signed: 08/12/2021 10:41:04 AM

Document Has Been Signed on 08/12/2021 10:41 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:SAUSD/ROMERO CRUZ ACADEMYFACILITY NUMBER:
304371294
ADMINISTRATOR:VELIMIROVICH, ROSAFACILITY TYPE:
850
ADDRESS:2701 W FIFTH STREETTELEPHONE:
(714) 431-7542
CITY:SANTA ANASTATE: CAZIP CODE:
92703
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/12/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Veronica Berber-Aceves, Early Learning SpecialistTIME COMPLETED:
11:00 AM
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An unannounced case management inspection was conducted on this date by Licensing Program Analyst (LPA) Stacy Torrence for the purpose of un-licensing two classrooms. The facility has requested to un-license classrooms: #2 and #3 and to keep classrooms: #1 and #4. The facility is currently licensed for 48 and is not requesting a capacity change. The facility is located on the Santa Ana School District, Romero Cruz Academy School campus. LPA Torrence met with Veronica Berber-Aceves, Early Learning Specialist, who guided analyst on a tour of the facility. The facility was closed for the summer; therefore, there were no children or staff present. Operations hours are Monday-Friday; the facility has a full day program; hours of operation; 8:00 a.m.-4:00 p.m. and half day program with two sessions; AM session; 8:00-11:00 a.m. and PM session; 12:30 p.m. -3:30 p.m.; serving children ages 2-5 years old. In classrooms: #1 and #4.


A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

All areas identified on the Facility Sketch were inspected. If children become ill during the day, they will rest in the isolation area located, in the front office, in the nurse’s office. There is also a bathroom in the office that will be used for the ill children. Medication will be stored in the classroom, in a locked file cabinet. Furniture and equipment were inspected for age appropriateness and good repair. Age appropriate sinks and toilets were inspected for availability, good repair, water temperature, toilet paper, paper towels, area safety and sanitation. Children bring their own water bottles from home and the school provide water, if needed. First Aid supplies were inventoried. Sign in / sign out record meets regulation requirements.

School provides breakfast, lunch, and snack for full day program and lunch for half day program. Facility pick up the food at the school cafeteria, located on campus.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2021
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: SAUSD/ROMERO CRUZ ACADEMY
FACILITY NUMBER: 304371294
VISIT DATE: 08/12/2021
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Indoor Activity Space Measurements:
Classroom #1: 39.02 x 32.06= 1,250.00 sqft.
Classroom #4: 39.02 x 32.06= 1,250.00 sqft.
Total= 2,500 sqft. divided by 35 = 71 children

Total children toilets and sinks:
Toilets: 5 x 15 = 75 children
sinks: 10 x 15 = 150 children

Outdoor Activity Space Measurements:
Outdoor: The outdoor measures for 4,802 sq ft = 64 children

Playground is completely enclosed. Outdoor activity area is supplied with age and size appropriate equipment. An adequate amount of cushioning material is in place under the equipment. Shade is provided by a umbrella and shade structure. Drinking water is available by children bringing their water bottles from home and a water jug is available for refills

Facility provides Incidental Medical services.

In the areas evaluated, no deficiency was observed and cited today per CA Code of Regulations, Title 22, and Division 12.

A license will be issued for the capacity of 48.

Exit interview was conducted. A copy of this report and appeal rights were discussed and provided to the director. The Notice of Site Visit was posted. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

End Report
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
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