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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606916
Report Date: 07/14/2021
Date Signed: 07/14/2021 12:03:07 PM

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:IRVINE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
300606916
ADMINISTRATOR:TUCKER, LISAFACILITY TYPE:
850
ADDRESS:2 CIVIC CENTER PLAZATELEPHONE:
(949) 724-6700
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY:73CENSUS: 42DATE:
07/14/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Lisa Tucker, DirectorTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Valencia conducted an on site inspection for the purpose of a Case Management Incident inspection, in response to an Unusual Incident Report submitted to the Licensing office on 7/9/21. LPA and the facility representative toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 42 preschool children with 12 preschool staff. Due to COVID 19 guidelines, LPA observed staff and children wearing face mask, social distancing and following CDC and Dept of Public Health Guidelines. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

An Unusual Incident Report UIR LIC624 form was submitted to the Licensing office on 7/9/21 detailing that a parent, adult #1 (see Confidential Names List LIC811) stated to director and staff #1 that their child, child #1 stated to them at home that a staff #2 may have violated their personal rights. During today's inspection, LPA Valencia conducted a physical plant inspection of the facility, observed the classroom and teacher to child interactions, reviewed a video of an interview with adult #1 and child #1 about the incident, and interviewed 5 staff. It was determined form the information available to LPA during the inspection, that the facility did not violate Title 22 Regulations related to personal rights of this incident. A printout of Title 22 Regulations Personal Rights was reviewed and provided for the director.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. An exit interview was completed with facility representative and The report was reviewed and discussed. The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
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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