304371609-2-9-2023-06-CC-MMAK-CNWA25-20230209224947

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371609
Report Date: 02/02/2023
Date Signed: 02/09/2023 10:50:58 PM

Document Has Been Signed on 02/09/2023 10:50 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:	D'S HOMEWORK ACADEMY		FACILITY NUMBER:	304371609
ADMINISTRATOR:	YOUNG, PEGGY		FACILITY TYPE:	840
ADDRESS:	18631 CHAPEL LANE		TELEPHONE:	(714) 968-3100
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92646
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 0	DATE:	02/02/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Director		TIME COMPLETED:	04:30 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 5 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced on site pre-licensing inspection at this childcare center for the purpose of change of ownership from license # 304370827 to operate a school age program. LPA met with the director, Peggy Young. LPA was given a tour with director of the school age rooms # 10, Youth Center, and Sacquety Hall. The applicant has requested to provide care and supervision for 60 children ages 4.9 to 12 years old, Monday through Friday 2:30 PM. to 6.00 PM except for Thursdays which is from 1:30 to 6:00 pm. LPA observed staff following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements. 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. According to director, there are 10 school age children will arrive after school on average daily. Parents sign in and out electronically if they drop them off. Staff sign the school age children if staff pick up from school, The entrance is from the rear site of the building entering the outdoor space to the classrooms. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities. Isolation area is the office, located at the entrance of the facility and there is an additional cot with bedding for the sick child in the Director's office. The bathroom for sick children is the staff bathroom. Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

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 5

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: D'S HOMEWORK ACADEMY	FACILITY NUMBER: 304371609
	VISIT DATE: 02/02/2023

NARRATIVE

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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)
· Personal Rights (LIC 613A)
· 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.

The following was observed in the classrooms # 10, Youth Center, and Sacquety Hall.

· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through personalized water bottles and drinking fountain.
· Sign in/Sign out procedure was reviewed.
· Facility has in-built smoke detectors & carbon monoxide detectors on the ceiling. There is one fire extinguisher mounted that meets statutory requirements.
· Cubbies available for storage of individual child’s personal belongings
· Facility not providing lunch and snack to children and those are provided by parents.
Rooms are well lighted with proper ventilation.
Medications are stored in the locked box if any.
First Aid kit and Emergency kit is present.
Classroom # 10 is a shared classroom between the preschool children and school age children. Preschool children in this room get dismissed at 2:30 pm except for Thursdays which is 1:30 pm. School age children arrive around 2:30 pm every day except for Thursdays that the arrival time is 1:30 pm. During the public school holidays, this room is closed to preschool children and is open to school age children full day.

Continued on page 3

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: D'S HOMEWORK ACADEMY	FACILITY NUMBER: 304371609
	VISIT DATE: 02/02/2023

NARRATIVE

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LPA measured the classrooms:

Classroom # 10 is: 765 square feet
Youth Center is: 1193 square feet
Sacquety Hall is: 2455.54 square feet
Total indoor capacity of the 3 spaces: 4413.54 square feet divided by 35= 126.10 (126 children)

Total sinks: 6 X 15= 90 children
Total toilets: 5 X 15=75 children
Urinal: 1X 5 =5 children

There is on sink in room # 10, and there are 2 sinks and one toilet in Youth Center. There is one urinal, one toilet, and 2 sinks in the boy's restroom in the Sacquety Hall, and there are 3 toilets, and 2 sinks in the girl's bathroom in the Sacquety Hall for school age children's usage. The director stated the use of Sacquety Hall is on the events the enrollment is high. They use room # 10 and Youth Center for low enrollment times.

Playground measurement: Outdoor activity space is 9589 square feet divided by 75 =127.85
(128 children).
This playground is shared with preschool children. The director was informed that a waiver request needs to be submitted.

The following was observed:
· Playground is fully enclosed by an appropriate fencing
· Outdoor activity space is supplied with age and size appropriate equipment, outdoor activity toys,
There are climbing structure with slide on the preschool playground with adequate amount of cushioning
Shade is provided by trees and umbrellas.
Drinking water is provided by children's own water bottles and drinking fountain on the outdoor space.

Continued on page 4

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: D'S HOMEWORK ACADEMY	FACILITY NUMBER: 304371609
	VISIT DATE: 02/02/2023

NARRATIVE

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Fire clearance received from Orange County Fire Authority approving the requested capacity of 60 school age children. The total measurements of the 3 spaces accommodate 60 school age children.

The director, Peggy Young is current on the required Immunization/ Pediatric CPR/ First training and has provided the completion certificate for the Preventive Health training (Nutrition and Lead component) and Mandated Child abuse reporting training.

Following items were discussed at the time of Exit interview.
Criminal Record Statement :The Director, Peggy Young 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.

Incidental Medical Services Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated 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

LPA reviewed the LIC 311A, Records to Be Maintained at the Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Continued on page 5

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: D'S HOMEWORK ACADEMY	FACILITY NUMBER: 304371609
	VISIT DATE: 02/02/2023

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Subscribe to CCLD important information

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 platform.

To receive important license 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Facility needs to complete the following items before a final license can be issued:

(1) Waiver request to share the preschool playground with school age program at different timing. For waiver request the following is needed.
LIC 999
LIC 500 for both programs
Picture of the playground
Outdoor schedule for preschool and school age programs.

License will be for a total of 60 school age children ages 4.9 to 12 years old in rooms # 10, Youth Center, Sacquety Hall, Monday to Friday 2:30 to 6:00 PM, except for Thursdays 1:30 to 6:00 pm. School Holidays from 7:00 am to 6:00 pm. Room # 10 for preschool use in the morning and school age use in the afternoon. The license will be issued upon receiving the above corrections and Management approval.

Exit interview conducted and report was reviewed with the director, Peggy Young.

End of reports

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

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