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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370006
Report Date: 05/22/2024
Date Signed: 05/22/2024 03:20:01 PM


Document Has Been Signed on 05/22/2024 03:20 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:LEARNING EXPERIENCE EARLY EDUCATION CENTER, THEFACILITY NUMBER:
304370006
ADMINISTRATOR:MCCALL, PAULINEFACILITY TYPE:
840
ADDRESS:23421 MADEROTELEPHONE:
(949) 770-9901
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:25CENSUS: 25DATE:
05/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:administrator, Inoka Jayasinghe and her assistant, Marie Roseline (Rosy) SebasteTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite case management for the purpose of delivering an amended report dated 5/16/2024.

LPA met with administrator, Inoka Jayasinghe and her assistant, Marie Roseline (Rosy) Sebaste . The director, Pauline McCall was not present.

The purpose of amending the report is to remove page 2 from the report (LIC809) dated 5/16/2024 and correct the report to page 1 of 1 instead of page 1 of 2. There is no page 2 attached to the report.
LPA took census. There was a total of 25 school age children with 2 staff on the playground. According to the self-incident report, 3 school age children ages 6 years old admitted to staff that they were using inappropriate words and did inappropriate behavior among themselves on the playground.
A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
The facility representative, Marie Roseline (Rosy) Sebaste was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.
The facility representative, Marie Roseline (Rosy) Sebaste , was provided with 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.
The exit interview was conducted with The facility representative, Marie Roseline (Rosy) Sebaste
End of report
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2024
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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