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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304205587
Report Date: 04/04/2023
Date Signed: 04/04/2023 10:18:09 AM


Document Has Been Signed on 04/04/2023 10:18 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:MALTESE, ROWENAFACILITY NUMBER:
304205587
ADMINISTRATOR:MALTESE, ROWENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 412-8165
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY:14CENSUS: DATE:
04/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Rowena MalteseTIME COMPLETED:
11:00 AM
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Census upon entry: 9
Infants: 3
Children Over Two: 6
Adults Working Directly with Children: 3
Other Adults: 0
LPA A. Bootorabi met with licensee Rowena Maltese on today's visit. The licensee and LPA reviewed the POC's that were due. Licensee had doors open to bedroom #1 and #2 where children nap. Licensee observed sleep logs during today's visit.

LPA and Licensee reviewed the LIC 9227 forms for five infants in her care. Licensee and assistant #3 were observed caring for children indoors and outdoors

During today's visit LPA and licensee reviewed some of the POC and confirmed LPA's email address for successful submission of the remaining POC.

LIcensee and LPA reviewed sample files for children and staff.

Licensee was given a copy of LIC 9224 for parents to sign. A consultation was provided regards documenting and filing this document.
The licensee understands they must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care for and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunizations, Pediatric CPR/First Aid, and mandated reporter training.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2023
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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