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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370736
Report Date: 05/22/2024
Date Signed: 05/22/2024 03:50:24 PM


Document Has Been Signed on 05/22/2024 03:50 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:FUN 4 KIDS PRESCHOOLFACILITY NUMBER:
304370736
ADMINISTRATOR:SILVA, DAWNFACILITY TYPE:
840
ADDRESS:23721 LA PALMA AVENUETELEPHONE:
(714) 694-0901
CITY:YORBA LINDASTATE: CAZIP CODE:
92887
CAPACITY:30CENSUS: 24DATE:
05/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director Alicia FloresTIME COMPLETED:
02:46 PM
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On 05/22/24 at 2:00pm, Licensing Program Analyst (LPA) Anna Chan made an unannounced visit to facility for the purpose of a case management visit. LPA met with interim director Rhonda Sparks. LPA explained the reason for today's visit upon arrival. Census was taken in the yard. LPA observed 24 school-age children and 2 staff. Director Alicia Flores arrived shortly after to continue with the visit.

A review of the Facility Personnel Report Summary conducted on today’s date indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today's visit, LPA interviewed 5 school-age children regarding possible co-mingling. Based on children interview, no deficiency cited.

Exit interview was conducted with facility representative and notice of site visit posted at entrance of facility. Notice of site visit is to remain posted for no less than 30 days.


End of Report
SUPERVISOR'S NAME: Martha MalaneTELEPHONE: (310) 740-3022
LICENSING EVALUATOR NAME: Anna Francesca ChanTELEPHONE: (818) 216-9775
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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