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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270605
Report Date: 02/16/2022
Date Signed: 02/16/2022 10:03:44 AM

Document Has Been Signed on 02/16/2022 10:03 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MARINERS CHURCH PRESCHOOLFACILITY NUMBER:
304270605
ADMINISTRATOR:SCIABICA, LISAFACILITY TYPE:
850
ADDRESS:5001 NEWPORT COAST DRIVETELEPHONE:
(949) 769-8261
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 194TOTAL ENROLLED CHILDREN: 194CENSUS: 100DATE:
02/16/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jennifer Eggers, DirectorTIME COMPLETED:
10:00 AM
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LIcensing Program Analyst (LPA) P Rivas conducted a case management visit in order to complete the annual inspection that was commenced on 02/07/22. LPA was assisted by Director Eggers.A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance. A Facility Risk assessment was conducted to determine the level of Personal Protective Equipment (PPE) was needed for an on-site inspection.

LPA viewed inspection for smoke alarm system and tested carbon monoxide detectors and completed children file reviews on 02/20/22.

No deficiencies were noted during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Ms. Eggers.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2022
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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