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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371581
Report Date: 08/20/2024
Date Signed: 08/20/2024 04:11:30 PM

Document Has Been Signed on 08/20/2024 04:11 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:PIPER IRVINE LLC.FACILITY NUMBER:
304371581
ADMINISTRATOR/
DIRECTOR:		SIEM, CLAUDIAFACILITY TYPE:
850
ADDRESS:8673 IRVINE CENTER DRIVETELEPHONE:
(949) 570-4011
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 185TOTAL ENROLLED CHILDREN: 185CENSUS: 86DATE:
08/20/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Assistant Director, Michelle NazzarenoTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA), Nunez conducted a visit for the purpose of a Plan of Correction (POC). LPA was given a tour of the preschool classrooms inside and outside by Assistant Director Michelle Nazzareno. LPA observed the facility was following CDC and Dept of Public Guidelines. Census was taken. There was a total of 80 preschool children with 21 staff members and 6 toddlers with 4 staff members present today.

A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.


On 08/19/2024 LPA conducted a 3-year annual inspection. LPA observed a creek with running water in the children’s paly ground. Children had access to the creek poses an immediate health, safety, or personal rights risk to persons in care. A Type A citation was given according to Title 22 101238(e) Buildings and Grounds All licensees shall ensure the inaccessibility of pools, including swimming pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds or similar bodies of water, through a pool cover or by surrounding the pool with a fence.

On 8/20/2024 In the areas that were evaluated, the plan of correction was in compliance. LPA observed the water turned off on the creek and assistant director stated they notified all the staff and parents that the creek was closed.

In the areas that were evaluated, NO deficiencies were observed in the California Code of Regulations, Title 22, Division 12 at the time of the visit.


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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: PIPER IRVINE LLC.
FACILITY NUMBER: 304371581
VISIT DATE: 08/20/2024
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Exit interview conducted and report was reviewed with the assistant director Michelle Nazzareno. 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.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) 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. First level appeals should be sent to the regional manager to the address listed above.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
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