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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371247
Report Date: 08/17/2023
Date Signed: 08/17/2023 05:17:59 PM


Document Has Been Signed on 08/17/2023 05:17 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:MILESTONES MONTESSORI OF LAKE FORESTFACILITY NUMBER:
304371247
ADMINISTRATOR:PATOPOFF, JAMIEFACILITY TYPE:
850
ADDRESS:23222 LAKE CENTER DRIVETELEPHONE:
(949) 830-9999
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:189CENSUS: 34DATE:
08/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:PATOPOFF, JAMIETIME COMPLETED:
05:30 PM
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A case management visit was conducted by LPA A Bootorabi on 8/17/2023.
LPA tour the preschool classrooms Orange, Yellow and Red.

Census was as followed: Red 12 Students & 2 Teachers / Orange 11 Students and 1 Teacher / Yellow 11 Students and 1 Teacher

LPA requested completed teacher files for review at 3:39 pm . LPA finished file review at 4:51 pm. LPA discussed quarter and semester units with director. The director will be completing LIC9095 and verifying teacher qualifications. Director stated that she will be using qualified staff in the meantime.

A consultation was provided for a mandated reporter training expired 8/4/2023.

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.

The facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to the initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

No citations were provided.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023
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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