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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371512
Report Date: 07/01/2021
Date Signed: 07/01/2021 02:09:26 PM

Document Has Been Signed on 07/01/2021 02:09 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:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
304371512
ADMINISTRATOR:PINVIDIC, LEAHFACILITY TYPE:
850
ADDRESS:21772 LAKE FOREST DRIVETELEPHONE:
(949) 859-0805
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 144TOTAL ENROLLED CHILDREN: 0CENSUS: 51DATE:
07/01/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Ms. Pinvidic, Leah and District Manager Ms. Keramati MariamTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a Change of Ownership. Emergency approval is valid through July14th 2021.
LPA met with Facility Director Ms. Pinvidic, Leah and District Manager of Learning Care group Ms. Keramati Mariam who gave a tour of the Child Care Center. The applicant has requested to provide care and supervision for 9, Toddlers (18 months - 36 months) and 135 Pre-school age children 2 to 6 years of age, Monday through Friday 7.00 am. to 6.00 PM. in the assigned seven classrooms. Due to COVID 19, LPA observed staff and children wearing face mask, social distancing and following CDC and Dept of Public Health Guidelines.

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 facility is located in a business complex, upon entering the facility through the glass door, there is a front lobby area, where facility staff receive the children and are lead into the classrooms. The seven assigned classrooms are located in two separate buildings.

Five Preschool classrooms are in the back side of the facility next to the preschool yard and they have their own entrance while the main building has three classrooms including one infant room , one toddler room and one Preschool room for younger preschoolers.

Due to COVID Pandemic parents are encouraged to follow the CDC and COVID requirements, children are received at the entrance door by the staff, temperatures are checked, hands are sanitized before they are taken to their classrooms. Parents sign them in at the front lobby electronically. (Page-1)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2021
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 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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512
VISIT DATE: 07/01/2021
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Medication will be stored in each classrooms in a locked cabinet and shall be administered by the teacher or the Facility in charge, emergency First Aid kits are stored in the classrooms and in the in assigned cabinets. Medication administration forms were reviewed.
Isolation area is the Director’s office and the sick child shall use the adult restroom located in the Toddler classroom, there an additional matand linens for the sick child.

The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through water pitchers with disposable cups
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Electronic sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements.
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Mats are used and are stored at the end of the classroom, napping linens and blankets are provided by the parents.
· Facility provides two snacks and lunch,is brought from home. Facility has a designated Kitchen area where snacks are prepared and taken to the classrooms. Kitchen was observed to be free of vermicides.

LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393) (Page-2)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
LIC809 (FAS) - (06/04)
Page: 2 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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512
VISIT DATE: 07/01/2021
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· Personal Rights (LIC 613A)
· Menus / Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies / Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269)
· COVID Posters.

Indoor measurements : TODDLERS
Room # 7: Toddler room (small area): 9'17 x 6'5 = 59'61
Room # 7 : Toddler room (Big area) : 14'92 x 10'58 = 157'85

Total indoor space : 217'46 divided by 35= 6.21 ( 6 Toddlers)

Outdoor Toddler yard : 29'67 x 17'50 = 519'23
Total outdoor space: 519'23 divided by 75= 9'92 (7 toddlers)

There is one sink in the classroom with a changing table within arm's reach. There is no Toilet training in the classrooms.

Room # 7 (Toddler room) has space only for 6 toddlers age (18 months- 36 months)

Indoor Measurements: Preschool ( Room # 1,2,3,4,5 and 8)
Room # 1 
37.58
28.17
1058.63
1058.63
Room # 2 
28.33
13.67
387.27
17.35
369.92
Room # 3
47.67
19.5
929.57
40.50
889.07
Room # 4 (big area)
27.42
19.5
534.69
0.00
534.69
Room #4 (Small area) 
23.17
10.17
235.64
0.00
235.64
Room # 5 
55.92
19.67
1099.95
22.48
1077.47
Room # 8 (Big area) 
51.83
9.42
488.24
488.24
Room # 8 (small area0
16.33
7.5
122.48
40.5
81.98
Total indoor space: 4735'62 divided by 35 = 135'30 (135 children) Page-3)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512
VISIT DATE: 07/01/2021
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Total sinks: 15 X 15= 225 (children) / Total Toilets: 14 X 15= 210 (children)
There are sufficient toilets and sinks in the facility

Toilets and sinks were observed to be age appropriate. Bathrooms were clean and accessible to children. The facility has communal toilets and sinks in-between Preschool classrooms

Preschool yard: Outdoor measurements
Big Yard: 120 x 53 = 6360
Small area: 62 x 35 =2170

Total outdoor space: 8530 divided by 75= 113. 73 ( 114 children)

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers with small disposable cups
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor activity toys,
· An adequate amount of cushioning material consisting soft cushion is in place under the play structures
· Adequate shade is provided by shaded structure (Canopy)and benches are placed.
· There are two areas are also utilized by Preschool area

Based on the indoor and outdoor measurements, sink and toilet availability, facility has enough space to accommodate 6 Toddlers (18 months to 36 months and 135 Preschool children ( 2-6 years old) in the assigned seven classroom including one toddler room.

Fire clearance received from Orange County Fire Authority have approved the requested capacity of 156 children in the seven assigned rooms. ( Preschool/ Toddlers and Infants)

Facility Administrator is current on the required Immunization/ Pediatric CPR/ First training valid through 11/2021 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component) (Page-4)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512
VISIT DATE: 07/01/2021
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The applicant was given a pamphlet on Lead Exposure and was discussed with provider. Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org. The Chaptered Legislation for AB 2084 (Nutritious Beverages) is available to view on the website at: http://ccld.ca.gov/res/pdf/12APX-11.pdf

Applicant was informed of Mandated Reporter Training for self and all assistants. Department web site form was given to down load forms, Title 22 regulations, and training's on-line at www.ccld.ca.gov. The applicant was also informed to visit the website for Quarterly Updates. The applicant was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: 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 applicant/facility representative 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

The facility was following Title 22 requirements at the time of the inspection. Based on today’s measurements, and the sink and toilet availability, this center has enough activity space to support the capacity of only 6 Toddlers in Room # 7 and 135 Preschool children in (Room # 1,2,3,4.5 and 8)

A license will be issued for the capacity of 6 Toddlers (18- 36 months ) and 135 preschool children age 2-6 years old, after a final review. The applicant will be notified if any additional information is required.

Applicant was also advised, once licensed, the Notice of Site Visit must be posted for 30 days and if A violations are cited then the Licensing Report (LIC809 or 9099) must be posted by the Notice of Site Visit for a period of 30 days or $100 civil penalties will be assessed, and the report shall posted and copies provided to the parents/guardians of the children in care at the facility by the next business day, (Page-5)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512
VISIT DATE: 07/01/2021
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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

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The applicant was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
LIC809 (FAS) - (06/04)
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