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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304205597
Report Date: 06/27/2019
Date Signed: 06/27/2019 04:27:19 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:LENZINI, JEANETTEFACILITY NUMBER:
304205597
ADMINISTRATOR:LENZINI, JEANETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 594-0247
CITY:LOS ALAMITOSSTATE: CAZIP CODE:
90720
CAPACITY:14CENSUS: 4DATE:
06/27/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Jeanette LenziniTIME COMPLETED:
05:00 PM
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An inspection was conducted by LPA Dean Valencia. LPA met with the licensee. This inspection is being conducted in response to two A violations cited on 6/20/19 during an annual inspection. On 6/20/19, the facility had 10 children in care, and 5 of which were infants. An assistant was present providing care along with the licensee, although often an assistant is not available at the facility when the facility surpasses small FCCH capacity and ratio. The facility was cited two separate A violations at the time of the annual inspection on 6/20. These were both cited as A violations and determined to be immediate threats to the children's health and safety. In response to the violations the licensee stated she will immediately stop providing care for several of the children, and stated she will always have an assistant available when surpassing small FCCH capacity and/or ratio. During today's Plan of Correction inspection, it was observed that 4 children were in care, 1 of which was an infant. During today's Plan of Correction inspection, it was observed that the facility was within compliance of ratio, capacity, and physical plant regulations. A ratio pamphlet, lead testing pamphlet, safe sleep concepts, and Guide to Safe Sleep was provided to the licensee and were discussed with the licensee at the time of the inspection on 6/20.

Exit interview was conducted, and report was reviewed and discussed with assistants. Notice of Site Visit was posted during the visit. The licensee and licensee's spouse were informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100 per day. The assistants were provided a copy of the appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional manager, address is above on the report.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: 714-703-2817
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019
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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