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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371216
Report Date: 12/18/2023
Date Signed: 12/18/2023 02:34:30 PM

Document Has Been Signed on 12/18/2023 02:34 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:LEPORT-IRVINE SPECTRUM -SOUTH CAMPUSFACILITY NUMBER:
304371216
ADMINISTRATOR:RIVAS, ANAFACILITY TYPE:
830
ADDRESS:1 TECHNOLOGY DRIVE BLDG HTELEPHONE:
(949) 525-9922
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 36TOTAL ENROLLED CHILDREN: 26CENSUS: 16DATE:
12/18/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Ana RivasTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 12/5/2023. LPA met with Director, Ana Rivas. LPA observed 16 infant children with 6 staff members.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 12/5/2023, a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported on 12/1/2023, a child fell inside the Rosemary classroom. On Saturday,12/2/2023, the director received an email from the parents stating on Friday 12/1/2023 the child was not barring weight on the left leg. On Saturday 12/2/2023 the parent stated the child would cry during diaper changes. The parent took the child to urgent care Saturday, 12/2/2023 and X-rays showed the child had a fracture on the left leg.

During today's inspection, LPA interviewed Director and staff members who were present inside the Rosemary classroom when the incident occurred. LPA reviewed the child file and staff files, obtained a copy of the children’s roster and obtained copies of the child incident reports.

Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview conducted and report was reviewed with Director Ana Rivas. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2023
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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