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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371218
Report Date: 05/08/2024
Date Signed: 05/08/2024 01:00:25 PM

Document Has Been Signed on 05/08/2024 01:00 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:LITTLE MINDS LEARNING CENTERFACILITY NUMBER:
304371218
ADMINISTRATOR/
DIRECTOR:		GONZALEZ, AMANDAFACILITY TYPE:
850
ADDRESS:8760 CERRITOS AVETELEPHONE:
(714) 699-1111
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 17DATE:
05/08/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Director Amanda GonzalezTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
NARRATIVE
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On 5/8/2024, at 12:45pm Licensing Program Analyst (LPA) Anna Chan conducted an unannounced complaint visit. Upon arrival, the LPA met with Director Amanda Gonzalez. LPA informed director of the purpose of visit. LPA was led on walk through of the facility by the staff and a census was taken. LPA observed 2 staff and 17 preschool children.

During the course of a complaint investigation, LPA discovered that based on an interview, director, Amanda Gonzalez stated facility did not report the unusual incident that occurred on 5/2/24 to the Department.

LPA provided and printed a copy of Reporting Requirement Regulation 101212(d)(1)(C)

Based on record reviewed the following deficiency was discussed and cited. The facility was not in compliance with the California Code of Regulations, Title 22, Division 12, Section 101212(d)(D) Reporting Requirements. Please refer to 809D for details of deficiency.

Exit interview was conducted. Notice of Site Visit was posted during the visit. Director Amanda Gonzalez 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. Appeal rights provided and explained. The Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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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Document Has Been Signed on 05/08/2024 01:00 PM - It Cannot Be Edited


Created By: Anna Francesca Chan On 05/08/2024 at 12:36 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LITTLE MINDS LEARNING CENTER
FACILITY NUMBER: 304371218

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/13/2024
Section Cited
CCR
101212(d)(1)(C)

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(d) Upon the occurrence, during the operation of the child care center...a report shall be made to the Department by telephone or fax within the Department's next working day (1) Events reported shall include the following:(C) Any unusual incident or child absence that
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Director stated she will send a statement to LPA that the facility will report any incident immediately to the Department as soon as it happens within the time frame, and will provide a copy of LIC624 of the incident that took place on 5/2/24 by due date of 5/13/24
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threatens the physical or emotional health or safety of any child. This requirement is not met as evidence by:
Based on interview, staff stated the facility did not report to licensing office about the incident between that a child went out of the facility front door without supervision.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Martha Malane
LICENSING EVALUATOR NAME:Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:
DATE: 05/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2024


LIC809 (FAS) - (06/04)
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