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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371486
Report Date: 03/17/2025
Date Signed: 03/17/2025 03:44:07 PM

Document Has Been Signed on 03/17/2025 03:44 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:GREAT FOUNDATIONS MONTESSORI-NORTHWOODFACILITY NUMBER:
304371486
ADMINISTRATOR/
DIRECTOR:
JANACK PERAZAFACILITY TYPE:
850
ADDRESS:4980 IRVINE BLVD.TELEPHONE:
(714) 389-9500
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 15DATE:
03/17/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Director, Kelli RenaultTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
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Page One

Licensing Program Analyst (LPA) Castro conducted a case management inspection to follow up on a self-reported unusual incident that was submitted to Community Care Licensing (CCL) Regional Licensing Office on 03/07/2025. It was reported by Kelli Renault, Director via phone. According to director, Staff 1 (S1) approached Child 1 (C1) and used her torso and right leg to lean into the child causing the child to fall backwards. C1 did not sustain any injuries.

During today's inspection a tour of the facility was conducted and census was taken: LPA observed 15 preschool children in the classroom with 2 teachers. During today's inspection, the facility was observed operating within its licensed capacity and within compliance of staff to child ratios. A review of staff 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.

Some of staff and one child were interviewed. LPA also obtained pertinent documents.

Due to additional information needed, the above allegation needs further investigation. If any deficiencies were observed, disclosed, or discovered during today's visit, they will be addressed and cited at a later date.

Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Kelli Renault.

End of Report
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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