<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370984
Report Date: 09/25/2020
Date Signed: 09/25/2020 03:27:32 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:BIG ADVENTURE, INC.FACILITY NUMBER:
304370984
ADMINISTRATOR:MCKENZIE, LAKESHIAFACILITY TYPE:
840
ADDRESS:2219 W ORANGE AVENUETELEPHONE:
(714) 535-4312
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:60CENSUS: 9DATE:
09/25/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Program Director Crystal Lauture TIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Tele-Inspection due to COVID -19 State of Emergency

On 9/25/2020 at 3:00 PM Licensing Program Analyst (LPA) Connolly conducted a case management
investigation for an incident regarding personal rights that the facility self reported to the licensing office on
9/17/2020.

LPA Connolly met with Program Director Crystal Lauture. LPA notified the director that due to COVID -19, CDC and DPH guidelines of social distancing, a tele investigation is conducted.

Crystal Lauture said there was a total of 9 school age children and 1 staff present at the time of this tele investigation.
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.

During today's tele inspection the program director was interviewed.

The program director was informed that due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was not posted due to tele-investigation COVID -19
State of Emergency. Appeal Rights were explained. A copy of Appeals Rights (LIC 9058 1/16) will be
provided through email and your signature on this from acknowledges receipt of these rights. Report was discussed and reviewed. This report is to be on file and accessible for public review at the facility for at least three years.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Gesine ConnollyTELEPHONE: (714) 293-9314
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1