<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270860
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:49:48 AM

Document Has Been Signed on 09/10/2024 11:49 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:SANTA ANA UNIFIED SCHOOL DISTRICT MADISONFACILITY NUMBER:
304270860
ADMINISTRATOR/
DIRECTOR:		SAITO, JILLFACILITY TYPE:
850
ADDRESS:1124 HOBARTTELEPHONE:
(714) 972-6421
CITY:SANTA ANASTATE: CAZIP CODE:
92707
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 8DATE:
09/10/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Claudia Reeves (Lead Teacher)TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 9/10/2024, Licensing Program Analyst (LPA) A. Silva conducted a Case Management – Other request lead test documents and verify that source A was repaired. Upon arrival, the LPA met with Lead Teacher Claudia Reeves. An on-site Facility Personnel Report Summary review indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Census was 8 preschool children. The facility was operating within ratios and capacity. LPA spoke with Veronica Berber who emailed a copy of the report to the LPA. The source was repaired and retested 1/24/23. No lead exceedances.

Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was provided and must remain posted for 30 days. Exit interview conducted and report was reviewed with the daycare representative.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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 1