304371650-11-2-2023-06-CC-PRIS-CX6RSL-20231101131654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371650
Report Date: 11/01/2023
Date Signed: 11/02/2023 10:02:56 AM

Document Has Been Signed on 11/02/2023 10:02 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CYPRESS KINDERLAND PRESCHOOL		FACILITY NUMBER:	304371650
ADMINISTRATOR:	GUERRERO, LEONOR		FACILITY TYPE:	850
ADDRESS:	4539 WEST CERRITIOS AVENUE		TELEPHONE:	(714) 828-9000
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY: 70	TOTAL ENROLLED CHILDREN: 70	CENSUS: 16	DATE:	11/01/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Yogi Kang, Designated Applicant & Leonor Guerrero Director		TIME COMPLETED:	01:45 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	Licensing Program Analyst, (LPA )P Rivas and Licensing Program Manager, Monica Cuddy met with Designated Applicant Ms. Kang and Director Leonor Guerro and conducted an announced pre licensing inspection for a change of ownership application from license # 304370896. During visit LPA viewed 2 teachers and 9 children in room 1-2 and 1 teacher and 7 children in room 3-4 The applicant has requested to provide care and supervision to 70 preschool children ages 2 to 6 years old in Rm 1-2 and Rm3-4, Monday to Friday from 7:00 am to 6:00 pm. Applicant reported partitions separating rooms 1 & 2 and 3 and 4 were not in place during fire inspection. Applicant will resubmit lic 999. Parents sign in and out manually in each classroom. Isolation area is the director's office with an additional cot and bedding. The staff bathroom will be used if needed for the sick child until child is picked up. LPAs 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) · 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. The following was observed in the classrooms: Age appropriate furniture and equipment’s, Toys, tactile equipment's. Rooms are well lighted with ventilation. There is sufficient open area for the child to move. Storage cubbies are arranged to store personal belongings. Flooring carpeted.. Morning and afternoon snacks are provided by the facility and lunches are provided by the parents.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CYPRESS KINDERLAND PRESCHOOL	FACILITY NUMBER: 304371650
	VISIT DATE: 11/01/2023

NARRATIVE

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Water is provided in the children's water containers with their names on them. The facility refills the water for children if needed via Kitchen sink only.
Children sleep on cots. Beddings are provided by the parents and sent home to be washed on a weekly basis. LPA viewed extra bedding available.

LPA Rivas and LPM Cuddy Measured Rooms 1-2 and 3-4 for a total indoor capacity sufficient for requested capacity. Indoor square footage measured at 2753.03.
Outdoor space for preschool children are fully enclosed by an appropriate fencing, Outdoor activity space is supplied with age and size appropriate equipment, and outdoor activity toys. The play area is covered with adequate cushioning. There is a play structure on the outdoor activity space which has sufficient cushioning material (wood chips) around the falling zones. There are two exit gates leading to parking lot Shade is provided by covered patio area and trees.
Fire clearance received from Orange County Fire Authority approving the requested capacity of 70 preschool children.
The director, Leonor Guerrero is current on the required Immunization/Mandated Child abuse reporting training. Her EMSA Pediatric CPR/First training certificate is current. She also has EMSA approved Preventive Health and Safety training without lead poisoning training.
The facility representative, Ms. Kang 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
Applicant has advised that they will be providing Incidental Medical Services(IMS) but no children are currently using medication. IMS plan has been submitted.
The following information regarding ADA was provided: US Department of Justice (USDOJ)
toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CYPRESS KINDERLAND PRESCHOOL	FACILITY NUMBER: 304371650
	VISIT DATE: 11/01/2023

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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 platforms.
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. The facility representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Based on today’s indoor measurements., the sinks and toilets availability, the request of the facility for 70 preschool children in rooms 1-2 and 3-4 will be given a final review and discuss with management in the Regional Office and after receiving the following corrections.

The outdoor activity space measurements of 5108.8 allowed for 68 children.

The facility will be notified if any additional information is required. Exit interview conducted and report was reviewed with the designated applicant Ms. Kang.

The following is needed;

1- removing cabinets from outside room 3-4 .
2- Bracing and or ensuring bookshelves in all rooms do not have potential to topple over.
3- A waiver request for Outdoor Use.
4. Director's Lead training.
5. Facility sketch updating room numbers.

Applicant can submit pictures of; area outside room 3-4; brackets on bookshelves, by 11/08/23 Applicant will submit waiver request by 11/03/23. Applicant will submit copy of Director's training certificate after 11/11/23. Applicant will submit new lic 999 Facility sketch by 11/03/23
end of report

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

LIC809 (FAS) - (06/04)

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