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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371213
Report Date: 06/28/2023
Date Signed: 06/28/2023 10:44:07 AM

Document Has Been Signed on 06/28/2023 10:44 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:LEPORT-IRVINE SPECTRUM-SOUTH CAMPUSFACILITY NUMBER:
304371213
ADMINISTRATOR:RIVAS, ANAFACILITY TYPE:
850
ADDRESS:1 TECHNOLOGY DRIVE, BLDG HTELEPHONE:
(949) 525-9922
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 156TOTAL ENROLLED CHILDREN: 156CENSUS: 68DATE:
06/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Wendy DeCosta, Business ManagerTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Mila Quinto conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 6/19/2023. LPA met with Business Manager, Wendy DeCosta. LPA observed 68 preschool children with 14 staff members.

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.

On 6/19/2023 a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that Child 1 (C1) had seizure in the classroom and was taken to the hospital.

During today's inspection, LPA interviewed 3 staff members. LPA obtained a copy of the children’s roster and C1’s file. Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Business Manager, Wendy DeCosta was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2023
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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