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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312497
Report Date: 01/15/2020
Date Signed: 01/15/2020 09:09:58 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:ARREOLA, CINDYFACILITY NUMBER:
304312497
ADMINISTRATOR:ARREOLA, CINDYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 203-4495
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:14CENSUS: 8DATE:
01/15/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Cindy ArreolaTIME COMPLETED:
09:30 AM
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A Plan of Correction inspection was conducted by Licensing Program Analyst (LPA) Han Jungmi in response to two A violations issued during an Inspection on 1/9/2020. During the inspection on 1/9/2020, the facility was issued an A violation for being out or ratio compliance, and an A violation for using a baby bouncer that is not permitted in a licensed facility. It was observed during a file review and walk through that there are 5 infants and 3 preschool age children with a licensee and two staff. Also observed was a baby bouncer that is not permitted in a licensed facility in child care room. This was an immediate threat to the children's health and safety, and were issued as A violations during the inspection on 1/9/2020. On 1/9/2020, the licensee, Cindy Arreola contacted child#4’s parents to pick up immediately. Child#4 was removed from the facility at 10:35AM by grandmother. Licensee stated child#4’s last day at the facility was 1/10/2020 due to move. On 1/9/2020, the licensee removed a bouncer from the child care room and placed at the garage.

During today's Plan of Correction inspection, a census of children in care was taken, reviewed children’s files and staff files, and a physical plant inspection was conducted. There was a total of 4 infants and 4 preschool age children and 2 staff including licensee observed. A review of staff 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.

There were no Title 22 deficiencies cited during today's inspection.

Exit interview was conducted. The report was reviewed and discussed. Notice of Site Visit was posted during the visit. The 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 facility was provided a copy of their appeal rights (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights. The facility representative was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov This report is to be on file and accessible for public review at the facility for at least 3 years.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Jung Mi HanTELEPHONE: (714) 309-7211
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
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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