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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304202709
Report Date: 06/19/2023
Date Signed: 06/19/2023 01:56:08 PM


Document Has Been Signed on 06/19/2023 01:56 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:NOORIZADEH, MEHRI & TAJRISHI, MASHALLAHFACILITY NUMBER:
304202709
ADMINISTRATOR:NOORIZADEH, & TAJRISHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 910-2156
CITY:IRVINESTATE: CAZIP CODE:
92603
CAPACITY:14CENSUS: 0DATE:
06/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mehri NTIME COMPLETED:
02:30 PM
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mrs. Bootorabi. The LPA was greeted by the licensee Mehri N. The licensee explained that she has been closed since September 2023. The LPA consulted the licensee on the steps for closure. The LPA collected the license and a statement from the licensee stating she is no longer operating. No children were observed during today's visit.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Araceli BootorabiTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2023
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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