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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371084
Report Date: 09/28/2021
Date Signed: 09/28/2021 03:17:20 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:TEACHABLE MOMENTS CHILDREN'S CENTERFACILITY NUMBER:
304371084
ADMINISTRATOR:LE, AMYFACILITY TYPE:
850
ADDRESS:6900 W. GARDEN GROVE BLVD.TELEPHONE:
(714) 383-5999
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:30CENSUS: 16DATE:
09/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Amy Le, DirectorTIME COMPLETED:
03:35 PM
NARRATIVE
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An unannounced case management visit was conducted on this date by LPA Nguyen. The purpose for today’s visit was to follow up with the waiver request to serve 12 school-age children using the back classroom. Preschool children will not be using the back room. Facility is currently licensed for 30 preschool children.

LPA’s met with licensee and toured the facility. Census was taken as follow: 16 preschool children with 3 staff members including the licensee. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today’s inspection, LPA Nguyen observed the school-age classroom is set up and has adequate inside space for 12 children only. There is a restroom that uses for school-age children and will not share with preschool children. The facility indicated that she will mail a waiver request to share yard on rotating schedules between preschool and school age children. Licensee acknowledges that:

1. There shall be no more than 12 school-age children present at any given time.
2. The age of the school-age children shall not exceed 12 year.
3. There shall be no co-mingling of school-age children with the preschool children except between the first and last hour of the day.
4. The school-age children shall have their own classroom and restroom and shall not share with the preschool children.
5. The school-age children shall use the preschool play yard on a rotating basis and shall not be present on the play yard at the same time as the preschool children.
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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina NguyenTELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TEACHABLE MOMENTS CHILDREN'S CENTER
FACILITY NUMBER: 304371084
VISIT DATE: 09/28/2021
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After a tour of the center, no deficiency was observed. File will be submitted for approval as of today.

Exit interview conducted. 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 it will result in civil penalties of $100. “The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.”
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Tina NguyenTELEPHONE: (714) 292-2922
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
LIC809 (FAS) - (06/04)
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