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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370956
Report Date: 08/23/2023
Date Signed: 08/23/2023 11:35:51 AM

Document Has Been Signed on 08/23/2023 11:35 AM - 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:MILESTONES MONTESSORI OF IRVINEFACILITY NUMBER:
304370956
ADMINISTRATOR:GOLDEN, KRISTELFACILITY TYPE:
850
ADDRESS:16601 ARMSTRONG AVENUETELEPHONE:
(949) 553-0555
CITY:IRVINESTATE: CAZIP CODE:
92606
CAPACITY: 230TOTAL ENROLLED CHILDREN: 230CENSUS: 124DATE:
08/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Director, Kristel Golden TIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Aiddee Nunez conducted an unannounced case management investigation for the incident which the facility self reported to licensing office on 8/16/2023. On 8/16/23 Director Golden called Community Care Licensing to report an unusual incident which according to the incident report, occurred at the facility on 07/25/23. The director stated a child#1 (C1) claimed that teacher#1 (S1) hit C1.

LPA toured the facility and census was taken as follow: 10 preschool staff, 8 transitional preschool staff, and 3 toddler staff with 124 children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today's inspection LPA Nunez obtain the personnel report, children's roster, and interviewed 4 staff members including the director and assistant director and 5 children.

Due to insufficient information available at this time, the above allegations needs further investigation.

An exit interview conducted with Director Golden. Appeal Rights were explained. The Director 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 to the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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