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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846106
Report Date: 05/26/2022
Date Signed: 05/26/2022 01:21:39 PM


Document Has Been Signed on 05/26/2022 01:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:HAPPY WORLD PRESCHOOLFACILITY NUMBER:
334846106
ADMINISTRATOR:GALLEGOS, MARIAFACILITY TYPE:
840
ADDRESS:2641 GREEN RIVER RD STE 101TELEPHONE:
(562) 219-1045
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:12CENSUS: 0DATE:
05/26/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
12:33 PM
MET WITH:Manzar Farooqui, Mary GallegosTIME COMPLETED:
01:20 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Justin Giese and Samuel Lopez arrived at the facility to conduct a Case Management visit/inspection regarding a Decision in Order which was ordered on May 16, 2022 and became effective on May 26, 2022. The Decision and Order is regarding the Exclusion of Asma Farooqui, which is employed at the facility. The purpose for the visit/inspection was explained to Director Mary Gallegos. Licensee Manzar Farooqui later arrived at the facility and was briefed on purpose of the visit. LPAs toured the facility and took a census. LPAs observed 17 children in care. The subject, Asma Farooqui was not observed at the facility.

Although a copy of the Decision in Order was mailed out to the Respondent an additional copy was provided by LPA Giese to the Licensee Manzar Farooqui. Licensee acknowledged receipt and understanding of the Decision and Order which reads: Respondent Asma Farooqui is excluded from all facilities licensed by the Department, certified or approved by a licensed foster family agency and from holding the position of a member of the board of directors, executive director, or officer of the licensee of any facility licensed by the Department, for two (2) years from the effective date of this order, unless ordered by the Department.

No deficiencies cited during this visit



A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee Manzar Farooqui and Director Mary Gallegos.

SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin GieseTELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2022
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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