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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600825
Report Date: 04/04/2024
Date Signed: 04/04/2024 02:44:00 PM

Document Has Been Signed on 04/04/2024 02:44 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:RED HILL EVANGELICAL LUTHERAN CHURCHFACILITY NUMBER:
300600825
ADMINISTRATOR/
DIRECTOR:
CAAMANO, ANNA MARIAFACILITY TYPE:
850
ADDRESS:13200 RED HILL AVENUETELEPHONE:
(714) 544-3132
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 103TOTAL ENROLLED CHILDREN: 103CENSUS: 16DATE:
04/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Assistant Director Jessica HickeyTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
NARRATIVE
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Licensing Program Analyst (LPAs) Giselle Lucero and Patricia Duron conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 03/27/2024. LPA met with Assistant Director Jessica Hickey. LPAs observed 16 preschool age children with 3 staff.

A review of staff criminal clearance 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 or exemptions.

On 03/28/2024, a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The Facility reported Child #1 (C1) tripped on the stairs of the play structure, fell, and broke their left arm.

During today’s visit, LPA obtained a copy of the children’s roster, reviewed C1’s file, obtained copies of the incident report and took pictures of the play structure where the incident occurred.

LPAs attempted to interview Staff #1 (S1) that witnessed the incident and attempted to interview C1. Assistant director stated S1 and C1 are not present due to the preschool being closed for spring break but the facility offers a spring break camp for the week. C1 is not enrolled in the spring break camp and S1 is off for the week.

Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Assistant Director Jessica Hickey was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024
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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