<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605470
Report Date: 08/04/2022
Date Signed: 08/04/2022 02:49:25 PM


Document Has Been Signed on 08/04/2022 02:49 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:ST. ANDREW'S CHILDREN'S CENTERFACILITY NUMBER:
300605470
ADMINISTRATOR:JONES, CAROLYNFACILITY TYPE:
830
ADDRESS:4400 BARRANCA PARKWAYTELEPHONE:
(949) 651-0198
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:64CENSUS: 33DATE:
08/04/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Pamela Myles, Program SpecialistTIME COMPLETED:
03:15 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
On 08/04/2022 Licensing Program Analyst, Stella Gutierrez made an unannounced visit to the facility for the purpose of a plan of correction of deficiency that was cited on 07/21/2022. LPA, Gutierrez was met by Pamela Myles, Program Specialist who was explained the reason for today's visit. LPA observed 14 staff and 33 children during today's visit.

A review of the Facility Personnel Report Summary conducted on 08/04/2022 indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The facility representative was reminded that all adults 18 and over, 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.

On 07/21/2022 LPA, Gutierrez conducted a visit to the infant program that resulted in a type A citation for Personal Rights - A child sustained and injury while in care. LPA requested that the facility staff be provided a training relating to the incident that occurred at the facility. Facility Director, Carolyn Jones sent the proof of correction via email on 07/27/2022 that a staff meeting was conducted on 07/26/2022 providing information to all staff regarding the citation that was issued and best practices moving forward.

Exit interview conducted, citation Type A cleared today and no additional deficiencies cited. A notice of site visit and this report was provided to Program Specialist, Pamela Myles.

Page 1 of 1
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2022
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 1