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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270907
Report Date: 11/20/2024
Date Signed: 11/20/2024 11:23:37 AM

Document Has Been Signed on 11/20/2024 11:23 AM - 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:HILLSBOROUGH PRIVATE SCHOOLFACILITY NUMBER:
304270907
ADMINISTRATOR/
DIRECTOR:		STEPHANIE VERAFACILITY TYPE:
850
ADDRESS:4757 VALLEY VIEWTELEPHONE:
(714) 572-5696
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 97TOTAL ENROLLED CHILDREN: 97CENSUS: 13DATE:
11/20/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Licensee Lacy BonnerTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
NARRATIVE
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On 11/20/24, a case management inspection was conducted by Licensing Program Analyst (LPA) Anna Chan, who met with Licensee Lacy Bonner. Upon arrival there were 2 staff present and 13 preschool children in care.

During a licensing visit on 11/20/24, LPA observed that the Notice of Site visit dated 10/25/24 that LPA posted was not posted at the facility.

Based on observation, the following type B deficiency was discussed and cited. The facility was not in compliance with Health and Safety Code 1596.817(b)(2) Site visits; posting of notices; contents; citations for violations; duration of posting; civil penalties. Civil Penalty assessed.



Exit interview was conducted and report and deficiency were reviewed with licensee, Lacy Bonner. Notice of Site Visit was posted during the visit. Licensee, Lacy Bonner 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. The Licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.

End of Report

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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Document Has Been Signed on 11/20/2024 11:23 AM - It Cannot Be Edited


Created By: Anna Francesca Chan On 11/20/2024 at 10:44 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HILLSBOROUGH PRIVATE SCHOOL
FACILITY NUMBER: 304270907

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2024
Section Cited
HSC
1596.817(b)(2)

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 1596.817(b)(2) Site visits; posting of notices... (2) Failure by a licensed child day care facility or a family day care home to comply with paragraph (1) shall result in an immediate civil penalty of one hundred dollars ($100).
This requirement was not met as evidenced by:
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Licensee stated they will train the new director about posting requirement and they will send a document stating this deficiency will not occur again. Notice of Site Visit dated 10/25/24 was reprinted and posted by LPA.
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Based on LPA observation, the Notice of Site visit dated 10/25/24 that LPA posted the same day was not posted at the facility on 11/20/24
This poses a potential risk to health and safety of children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Martha Malane
LICENSING EVALUATOR NAME:Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


LIC809 (FAS) - (06/04)
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