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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606173
Report Date: 08/11/2021
Date Signed: 08/11/2021 12:02:32 PM

Document Has Been Signed on 08/11/2021 12:02 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:WESTMINSTER SCHOOL DIST. LAND CHILD DEV. CTRFACILITY NUMBER:
300606173
ADMINISTRATOR:MICHELLE MILLERFACILITY TYPE:
850
ADDRESS:15151 TEMPLE STTELEPHONE:
(714) 898-8389
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY: 240TOTAL ENROLLED CHILDREN: 0CENSUS: 100DATE:
08/11/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Michelle Miller, Program ManagerTIME COMPLETED:
11:45 AM
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On 08/11/2021, Licensing program analysts (LPAs) Nguyen and LPA Tran conducted a visit at the facility. The purpose of this visit was to conduct a Case Management Evaluation of the facility. LPA Nguyen and LPA Tran met with the program manager Michelle Miller and toured the facility inside and outside. Census was taken in individual classrooms. The overall census observed was 19 preschool staffs and 100 preschool children.

On 07/12/2021, the Licensing Office received a self-report an unusual incident. The facility filed Unusual Incident Report (UIR) stating that mother of Child #1 (C1) reported that C1 was itching private throughout the night. Mother asked C1 why C1 is itching. C1 disclosed that C1 does not know but while mom kept asking did something happen at school. C1 shared to C1’s mother that another friend touch C1 in C1’s private. C1 stayed with C1's father in the weekend. School representative talked to C1 and C1 denied that someone touch C1 at the school.

During the investigation, LPA Nguyen and LPA Tran interviewed 5 parents, 2 staff members, 3 children. Interviewed children did not disclosed anything, interviewed children indicated that teachers and friends are nice. C1 denied that someone touch C1 at the school. Interviewed staff members indicated that C1’s classroom is very opening with no blocking wall and the teachers are supervising the children at all time, including bathroom time usage. Interviewed parents stated that they are happy with the program and did not have any safety concern regarding supervision at the facility. Based on the interviews conducted and the information obtained, there is not a preponderance of evidence to support the child's disclosure. After a tour of the facility, no deficiency observed.
Exit interview was conducted. The Notice of Site Visit was posted. Program manager was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. “The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.”
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2021
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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