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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370736
Report Date: 05/10/2024
Date Signed: 05/10/2024 03:39:23 PM

Document Has Been Signed on 05/10/2024 03:39 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/
DIRECTOR:		SILVA, DAWNFACILITY TYPE:
840
ADDRESS:23721 LA PALMA AVENUETELEPHONE:
(714) 694-0901
CITY:YORBA LINDASTATE: CAZIP CODE:
92887
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 16DATE:
05/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Assistant Director Jessica MillerTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
NARRATIVE
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On 05/10/24 at 2:30pm, Licensing Program Analyst (LPA) Anna Chan made an unannounced visit to facility for the purpose of a follow up visit for the complaint that was received by the regional office on 05/08/2024. LPA met with Assistant Director Jessica Miller. LPA explained the reason for today's visit upon arrival. Census was taken. LPA observed 16 school-age children and 3 staff. Children was just dropped off from school pick up.

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.

LPA observed the name to face check in done by staff through the app in the classroom.

During today's visit, LPA interviewed 3 staff, took photos of the parking lot, took measurements from the parked vehicle to the entrance door, obtained screen shot of check in time, LIC500 and LIC9040.

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.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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