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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304310810
Report Date: 11/19/2024
Date Signed: 11/19/2024 02:29:37 PM

Document Has Been Signed on 11/19/2024 02:29 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:KEOUGH-SOMMA, GINAFACILITY NUMBER:
304310810
ADMINISTRATOR/
DIRECTOR:
KEOUGH-SOMMA, GINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 235-7946
CITY:DANA POINTSTATE: CAZIP CODE:
92629
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
11/19/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Gina Keough-SommaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/19/2024, Licensing Program Analyst (LPA) Thompson conducted an unannounced Case Management to ensure that the facility is staying within compliance of Title 22 regulations.

LPA and licensee Gina Keough-Somma toured the facility inside and outside. The floor and yard plan (LIC 999) were verified. LPA observed licensee caring for six children during todays visit. The facility was operating within its licensed capacity and within compliance of staff-to-child ratios.

An on-site Facility Personnel Report Summary review showed that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions.

During today’s inspection, LPA toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby safety locks and safety gates. The childcare area consists of living room, family room, kitchen, dining room, one bedroom located downstairs, and one bathroom across from the downstairs bedroom.

Licensee stated, they use the back yard for outdoor play, LPA inspected the back yard, and it was found to be incompliance. There is a pool in the backyard with self-latching gate and meets the title 22 regulations.

The licensee has a current roster of children in care. Children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700), Immunization records, Affidavit Regarding Liability Insurance (LIC282), Consent for Emergency Medical Treatment (LIC627), Notification of Parent’s Rights (LIC995A) and found to be in compliance.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KEOUGH-SOMMA, GINA
FACILITY NUMBER: 304310810
VISIT DATE: 11/19/2024
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The licensee has a current American Heart Association CPR/First Aid certification that expires 2/18/2025. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for licensee reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years. Licensee mandated reporter AB1207 certification expires 2/5/2025.

Children's records were reviewed, and there was a separate, complete, and current record for each child. Six children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary (LIC 700) and a medical assessment. In the areas reviewed the children’s files were found to be in full compliance.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA conducted an exit interview and reviewed the report with licensee Gina Keough-Somma. The “Notice of Site Visit” was posted, and the Licensee is aware that it shall remain posted for 30 days. The Appeal Rights were explained. The Licensee received a copy of the Appeal Rights (LIC 9058 01/16), their signature on this form acknowledges receipt of these rights.

End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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