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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300607122
Report Date: 08/19/2019
Date Signed: 08/19/2019 10:27:06 AM

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:CITY OF LA HABRA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
300607122
ADMINISTRATOR:ALVAREZ, MINERVAFACILITY TYPE:
840
ADDRESS:401 S. EUCLIDTELEPHONE:
(562) 905-9612
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:97CENSUS: 45DATE:
08/19/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:06 AM
MET WITH:Araceli Morales, Program SpecialistTIME COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Torrence conducted a case management inspection to follow-up with a self-reported incident received on 08/12/2019 regarding Personal Rights.

Upon arrival, LPA met with Araceli Morales, Program Specialist, who guided analyst on a tour of the Early Childhood Setting indoor. Catherine Villanueva, Child Development Manager arrived around 8:50 a.m. Census were taken as follow: 18 children with four staff in room #1, 15 children with three staff in room #2, and 12 children with two staff in room 3. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today's inspection, LPA obtained a copy of the Personnel Report and a current children’s roster. The facility does not have a current Police Report or Medical Report. LPA reviewed children's and staff records. LPA informed Ms. Villanueva that the Unusual Incident is assigned to an Investigation Bureau Investigator.

After the tour of the center and reviewing children and staff's records, no deficiency was observed.

The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The licensee was provided a copy of their appeal right (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.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019
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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