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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313763
Report Date: 05/05/2021
Date Signed: 05/05/2021 04:54:24 PM

Document Has Been Signed on 05/05/2021 04:54 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:VARGAS, MERIAMFACILITY NUMBER:
304313763
ADMINISTRATOR:VARGAS, MERIAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 801-0401
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
05/05/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Meriam VargasTIME COMPLETED:
05:00 PM
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On 5/5/2021 Licensing Program Analyst Jordann Nelson met with Licensee Meriam Vargas to conduct a Case Management visit in regards to a outdoor play area that was added to the rear of the home.

A review of personnel roster LIC 500 on this date indicated that all facility staff who required caregiver background checks have received criminal record and child abuse index clearances or exemptions There were 10 children and 2 teachers present at the time of the case management visit.

LPA Nelson conducted an safety inspection of the interior of the the home preschool which had a large room and a side room with a small restroom. The home was in clean and sanitary conditon.



The purpose of the visit was to inspect and ensure that the added play area at the rear of the home was suitable for the children to use. LPA Nelson observed the side yard has three small play structures that are place upon a cushioned green turf. The cushion green turf is safe to walk on. LPA Nelson did not observe any health or safety concerns in the outdoor area and the area is safe an suitable for outdoor play.

Exit interview was conducted with director Meriam Vargas. Report was read to Licensee A copy of the report along with Appeal Rights . All appeals must be in writing and received by the Licensing office within 15 business days.

End of report.

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Jordann Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2021
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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