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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370750
Report Date: 12/01/2022
Date Signed: 12/01/2022 01:41:23 PM

Document Has Been Signed on 12/01/2022 01:41 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:DOVE CANYON MONTESSORI SCHOOLFACILITY NUMBER:
304370750
ADMINISTRATOR:ZADEH, ATOSAFACILITY TYPE:
850
ADDRESS:31971 DOVE CANYON DRIVETELEPHONE:
(949) 589-4501
CITY:TRABUCO CANYONSTATE: CAZIP CODE:
92679
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 0DATE:
12/01/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director/Licensee Atosa ZadehTIME COMPLETED:
02:00 PM
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An Office Meeting was conducted on this day in the Orange Regional Office. Present during the meeting were Licensing Program Manager (LPM) Thuy Ho, Office Services Supervisor ll, Wende Tumbelston, Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek, Seasonal Clerk, Kathy Uribe and licensee/Director, Atosa Zadeh. The purpose of this meeting is to discuss the facility's outstanding balances for preschool program facility # 304370750 and the infant/toddler program facility # 304370751.

The facility has requested to increase the number of Toddlers from Toddler Option Component from 12 toddlers to 18 toddlers including the capacity of 72 children.

The following were discussed in today's meeting. The documents were reviewed regarding missing payments and late fees in the past. The licensee stated she did not receive any mail from licensing since her school was closed during pandemic. The licensee stated she is requesting the late fees to be waived from the previous annual fees. The licensee explained her hardship which affected her during pandemic.

It was agreed for the licensee to prepare a letter including documents explaining her hardship and reasons for not paying the outstanding fees so the upper management in Sacramento can review the letter and make the final decision.

The licensee was advised that increasing the number of toddlers shall be done after resolving the outstanding fees.

The licensee was provided a copy of their appeal right (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager; address is above on the report.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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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