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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371425
Report Date: 09/01/2020
Date Signed: 09/01/2020 02:00:24 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:GREAT ADVENTURES LEARNING CENTER INC.FACILITY NUMBER:
304371425
ADMINISTRATOR:JENSEN, SHARON A.FACILITY TYPE:
830
ADDRESS:7945 ALDRICH DRIVETELEPHONE:
(714) 847-0844
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:8CENSUS: 2DATE:
09/01/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sharon Jensen, directorTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Stacy Torrence conducted a unannounced case management incident inspection in response to a self-report Unusual Incident dated 08/28/2020. LPA met with Sharon Jensen, Licensee/Director. LPA toured the infant facility. Census was taken. LPA observed two napping infants, in individual cribs, with one staff supervising. 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 08/28/2020 an self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that a parent witnessed staff picking up child roughly, checking child’s diaper, then proceeded to shake child. This self-reported unusual incident was assigned to Investigator Hector Quintanar from Investigation Branch (IB). During today’s visit, LPA obtained an updated copy of the LIC 500 Personnel Report. 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. Director 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: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2020
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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