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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371091
Report Date: 03/01/2022
Date Signed: 03/01/2022 10:48:28 AM

Document Has Been Signed on 03/01/2022 10:48 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:KINDERLAND ACADEMYFACILITY NUMBER:
304371091
ADMINISTRATOR:SALCEDO, MIRIAMFACILITY TYPE:
850
ADDRESS:1170 W. CIVIC CENTER DRIVETELEPHONE:
(714) 280-4222
CITY:SANTA ANASTATE: CAZIP CODE:
92703
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 32DATE:
03/01/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Miriam SalcedoTIME COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Valencia conducted an on site inspection for the purpose of a Plan of Correction (POC) inspection. LPA and the facility representative toured the facility. Census was taken in individual classrooms. The overall census observed was 32 children and 7 staff. This POC inspection is being done in response to an A violation cited on 2/15/22, in which the 3-4s classroom was out of compliance, by having 13 children in care, being supervised by 1 staff. This violates ratio regulation, and is an immediate risk to children's health and safety. During today's inspection, it was observed that the facility was in compliance of ratio regulation and the facility has corrected this A violation. Also during today's inspection, LPA delivered an amended report to director, and gathered documentation from the director related to this amended report.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Appeal Rights and deficiencies were discussed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2022
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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