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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
304371693
Report Date:
06/25/2024
Date Signed:
06/25/2024 01:36:08 PM
Document Has Been Signed on
06/25/2024 01:36 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:
GRACE THERAPIES - CORPORATE SPONSORED CHILDCARE
FACILITY NUMBER:
304371693
ADMINISTRATOR/
DIRECTOR:
BRUNSTING, CLAIRE
FACILITY TYPE:
860
ADDRESS:
22722 LAMBERT STREET STE 1712
TELEPHONE:
(949) 329-8161
CITY:
LAKE FOREST
STATE:
CA
ZIP CODE:
92630
CAPACITY:
6
TOTAL ENROLLED CHILDREN:
6
CENSUS:
0
DATE:
06/25/2024
TYPE OF VISIT:
Office
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:
Claire Brunsting, Applicant
TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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LIcensing Program Analyst (LPA) conducted an office meeting with Ms Brunsting in order to obtain a corrected lic 200a and completion of financial information requested by her bank.
LPA also discussed the need for a waiver as outside activity space is under a different suite number. LPA discussed need for new lic 999 to include sketch of building complex.
LPA advised once sketch is received new fire clearance will be requested.
LPA advised file will be reviewed as soon as administratively possible.
An exit interview was conducted.
SUPERVISORS NAME
:
Monica Cuddy
LICENSING EVALUATOR NAME
:
Pat Rivas
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/25/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/25/2024
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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