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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304311418
Report Date: 12/14/2021
Date Signed: 12/14/2021 05:27:07 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:LEMUS, GLORIAFACILITY NUMBER:
304311418
ADMINISTRATOR:LEMUS, GLORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 835-3802
CITY:SANTA ANASTATE: CAZIP CODE:
92701
CAPACITY:14CENSUS: 6DATE:
12/14/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Gloria Lemus - LicenseeTIME COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA) Carmen Odom conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 12/10/2021. LPA met with Licensee Gloria Lemus. At 2:30pm LPA and licensee toured the facility. LPA observed 3 infants napping, and 3 school age children watching television. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 12/10/2021 an self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that adult#1 recorded and posted on social media false allegations regarding licensee and the childcare. During today’s visit, LPA obtained an updated copy of the children’s roster, recording, screen shots and interviewed licensee, 1 adult, and 3 children. Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Licensee 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.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021
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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