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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304310216
Report Date: 01/10/2025
Date Signed: 01/10/2025 12:18:30 PM

Document Has Been Signed on 01/10/2025 12:18 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:PALMERI, MIRNAFACILITY NUMBER:
304310216
ADMINISTRATOR/
DIRECTOR:		PALMERI, MIRNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 463-4544
CITY:ALISO VIEJOSTATE: CAZIP CODE:
92656
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
01/10/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Mirna PalmerTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 1/10/2025 at 11:15am, Licensing Program Analyst (LPA) Olivia Meza & Licensing Program Manager (LPM) Martha Malane, conducted a case management deficiency inspection. Upon arrival, LPA met with Licensee, Mirna Palmeri. There were six (6) children two (2) infants and four (4) preschool children and the Licensee's husband.

Based on LPA's observations, 2 out of 2 play yards for infants had loose objects (sheet and blankets). There were no children observed to be sleeping at the time the deficiency was observed. The licensee stated that the play yards are used for infants during nap time.



One Type B deficiency was cited per the California Code of Regulations, Title 22, Division 12 Section101439.1(f); see attached LIC809D.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Exit interview was conducted with Licensee, Mirna Palmeri. The Notice of Site Visit was posted for no less than 30 consecutive days. Appeal Rights were explained.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Olivia Meza
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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 2
Document Has Been Signed on 01/10/2025 12:18 PM - It Cannot Be Edited


Created By: Olivia Meza On 01/10/2025 at 11:25 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: PALMERI, MIRNA
FACILITY NUMBER: 304310216

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2025
Section Cited
CCR
102425(b)

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102425(b) crib or play yards shall be free from loose articles and objects. This requirement was not met as evidenced by:
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Licensee immediately removed the loose articles from the play yards and licensee stated she will send a sleep plan to the department by 1/17/2025 via email.
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Based on LPA's observation, and interview 2 out of 2 play yards for infants had loose objects (sheet and blankets) which poses a potential risk to health and safety or personal rights to 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:Olivia Meza
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2025


LIC809 (FAS) - (06/04)
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