<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270266
Report Date: 08/25/2023
Date Signed: 08/25/2023 04:25:36 PM

Document Has Been Signed on 08/25/2023 04:25 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:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
304270266
ADMINISTRATOR:VASQUEZ, JENNYFACILITY TYPE:
850
ADDRESS:705 EAST BIRCH STREETTELEPHONE:
(714) 256-2010
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY: 107TOTAL ENROLLED CHILDREN: 107CENSUS: 28DATE:
08/25/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Jenny Vasquez, Director TIME COMPLETED:
04:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Patricia Duron conducted an investigation regarding a self reported unusual incident. LPA observed 28 infants and 8 infant staff members in the infant classrooms.

A review of facility Personnel Report Summary 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. During today's inspection, LPA Duron interviewed 6 staff, and review files (children and staff) LPA obtained facility roster.

Due to insufficient information available at this time, this report needs further investigations.

An exit interview conducted with Director . The Director was provided a copy of appeal rights (LIC 9058 ) 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.

Notice of Site Visit was provided and must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1