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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370482
Report Date: 10/20/2023
Date Signed: 10/20/2023 02:34:13 PM


Document Has Been Signed on 10/20/2023 02:34 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:BRIGHT HORIZONS SAN CLEMENTEFACILITY NUMBER:
304370482
ADMINISTRATOR:VANTA, KELLIFACILITY TYPE:
850
ADDRESS:2015 CALLE FRONTERATELEPHONE:
(949) 492-5555
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY:144CENSUS: 70DATE:
10/20/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:VANTA, KELLITIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst is conducting a continuation of the annual inspection conducted on 10/18/2023. LPA met with the Assistant Director Ramos, Cristina upon entry and conducted a tour of the facility. After the tour the LPA met with the Director VANTA, KELLI.

Census was taken upon entry of each classroom:
Trestles: 15 Children 2 Staff Calafia: 8 Children 2 Teachers
Room 204: 10 Children 2 Teachers SC Pier Inside: Inside 8 Student 1 Teacher
SC Pier Outside: 9 Student 1 Teacher Riviera: 6 Children 1 Staff TK Room: 14 Children 2 Teachers

Documents reviewed and to be posted in a prominent, publicly accessible area at the facility: Facility License, Waivers (if applicable), Menus, LIC 613A Personal Rights, PUB 269, PUB 393 Notification of Parent Rights, and LIC 610 Emergency Disaster Plan. The following documents were posted by the front door: (1) License and (2)Personal Rights. A consultation was provided on 10/18/2023 for the remaining documents missing to be posted. The facility was missing PUB 269, Notification of Parent Rights, and Emergency Disaster Plan and a consultation was provided during today's visit.

CLASSROOMS: Classrooms 6 of 6 were toured with the director. Classrooms 6 of 6 were inspected and the activity space, and items that could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children.

PERSONNEL RECORDS : The LPA requested to review staff records of adults working directly with children. The following documents were requested for review exemptions or exemptions, Staff Qualifications, Immunization Records, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to report Child Abuse, 1 CPR First Aid Certification of staff present at the facility at all times, TB clearance, and a Mandated Reporter Training Certificate.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2023
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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Document Has Been Signed on 10/20/2023 02:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: BRIGHT HORIZONS SAN CLEMENTE
FACILITY NUMBER: 304370482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2023
Section Cited
CCR
101169(d)(18)

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101169(d)(18)... child passenger restraint systems pursuant ...Based on LPA's bservation upon entrance the Child Passenger Restraint form was not posted which poses a potential health, safety or personal rights risk to persons in care.
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The director posted the Passenger Restraint during today's visit. The director stated that moving forward she will ensure it is up at all times.
Type B
10/23/2023
Section Cited
CCR
101218.1(c)

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101218.1(c)The licensee shall post the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster in a prominent, publicly accessible area in the child care center at all times.Based on LPA's bservation upon entrance PUB 393 form was not posted which poses a potential
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The director posted the PUB 393 during today's visit. The director stated that moving forward she will ensure it is up at all times.
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 health, safety or personal rights risk to persons in care which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: BRIGHT HORIZONS SAN CLEMENTE
FACILITY NUMBER: 304370482
VISIT DATE: 10/20/2023
NARRATIVE
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A consultation was provided for personnel records during today's visit. Immunization records (S6, S1) and LIC 503(S1) were incomplete or missing.

Infant Safe Sleep Consultation occurred around 2 pm during inspection. LPA email regulations, sample logs and frequently asked questions to the director. The director had no further questions during exit interview regarding infant safe sleep.

Child Care Licensing Program Webinars: The Child Care Licensing Program is pleased to continue offering webinars to share important information with the childcare licensing community in 2023.
• Tuesday, December 12, 2023, 6:00 p.m.
To register for webinars, see Provider Information Notice (PIN), PIN 22-30-CCP.

The facility did not meet the California Code of Regulations, Title 22 Division 12, and regulations not met were observed, discussed, and cited at the time of the visit.

The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today:101169(d)(18), 101218.1(c), 1596.7995(a)(1)101429(a)(2)(C), 101216.1(c)

Director stated she would be interested in TSP.

Notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee VANTA, KELLI.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) 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. First-level appeals should be sent to the regional manager at the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817.
End of Report
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 10/20/2023 02:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: BRIGHT HORIZONS SAN CLEMENTE
FACILITY NUMBER: 304370482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/20/2023
Section Cited
CCR
101429(a)(2)(C)

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101429(a)(2)(C) Responsibility for Providing Care and Supervision for Infants: (C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
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The director began doing 15 min check as of 10/19/2022. LPA emailed regulations, sample logs, and frequently asked questions during inspection. The director stated that she will be ensuring that teachers understand the requirement and provide them with the necessary tool to complete logs.
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Based on LPA's bservation, interview with S3 and director the facility was not completing 15 min infant safe sleep logs which posed a potential health and safety risk to persons in care.
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Type B
10/27/2023
Section Cited
HSC1596.7995(a)(1)

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General Provisions and Definitions
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
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The director stated that she believes she has records for S1 but will auditing files to ensure she has documentation needed in files pre regulations. The director will have this task completed by Oct 31, 2023. The director will provide a statement of completion no later than 10/31/2023.
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Based on LPA's record review and interview with the director, the licensee did not comply with the section cited above by means of not having an immunization record for S6 and S1 which poses/posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 10/20/2023 02:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: BRIGHT HORIZONS SAN CLEMENTE
FACILITY NUMBER: 304370482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2023
Section Cited
CCR
101216.1(c)(1)

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(1) Twelve postsecondary semester or equivalent quarter units in ECE or CD completed, with passing grades... Based on LPA's request for completed qualified staff files on 10/18/2023 and LPA's observation and record review for fully qualified staff on 10/20/2023 the facility had two classroom without a fully qualified
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The director stated she will be applying for exceptions for staff S3 and S1. The director will have it mailed in to the department by Oct 27, 2023.
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had two classroom without fully qualified staff which posed a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2023
LIC809 (FAS) - (06/04)
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