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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371176
Report Date: 09/19/2024
Date Signed: 09/19/2024 09:43:19 AM


Document Has Been Signed on 09/19/2024 09:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:LEARNING LAB PRESCHOOLFACILITY NUMBER:
304371176
ADMINISTRATOR:DESIREE CAMACHOFACILITY TYPE:
850
ADDRESS:5000 BARRANCA PKWYTELEPHONE:
(949) 355-3071
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:60CENSUS: 23DATE:
09/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director-Flora AminiTIME COMPLETED:
09:50 AM
NARRATIVE
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An unannounced Case Management inspection conducted on this date by Licensing Program Analysts (LPAs) Navar met with Director Flora Amini to provide the facility a copy of an amended LIC 809 report dated 9/05/2024 to obtain signatures. LPA observed 6 staff 23 preschool age children.

A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

Please see "Amended" LIC 809 report dated 9/19/2024 for corrections.

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

Exit interview was conducted with Director Flora Amini. Notice of Site Visit was posted during the visit. Licensees 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. Administrator was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.

SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Karen NavarTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2024
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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