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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304310159
Report Date: 02/22/2024
Date Signed: 02/22/2024 01:47:11 PM

Document Has Been Signed on 02/22/2024 01:47 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:PEREIRA, BELINDAFACILITY NUMBER:
304310159
ADMINISTRATOR:PEREIRA, BELINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 717-3509
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
02/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:43 AM
MET WITH:Director Belinda PereiraTIME COMPLETED:
01:15 PM
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This is a follow-up proof of correction inspection that was made by Licensing Program Analyst (LPA) Romy Castanon and LPA Christine Jung. There were 12 children and Assistant #1 (A1) at the time of visit.

A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

A visit was conducted on 02/21/2024.

The following deficiencies that were previously cited on 02/21/2024 have been cleared:

1. 102416.5 Staffing Ratio and Capacity – Based on LPA’s observation, there were 12 children including 3 infants at the time of visit. Licensee provided an updated children’s roster and weekly calendar that shows the expected number of children to attend each day that complies with the capacity stated on her license.

A notice of site visit was posted today, and licensee was explained that it must remain posted for a period of 30 days. Failure to keep A Notice of Site Visit posted will result in a $100.00 civil penalty.

An exit interview was conducted, and a copy of this report was provided to Licensee Belinda Pereira.

The licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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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