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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371099
Report Date: 01/25/2023
Date Signed: 01/25/2023 02:54:24 PM

Document Has Been Signed on 01/25/2023 02:54 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MILESTONES ACADEMY CHILDCARE CENTER, INC.FACILITY NUMBER:
304371099
ADMINISTRATOR:GHARAVI, SAEIDEHFACILITY TYPE:
850
ADDRESS:23184 EL TORO FRONTAGE ROADTELEPHONE:
(949) 588-7000
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 16DATE:
01/25/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Saeideh GharaviTIME COMPLETED:
03:20 PM
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Licensing Program Analysts(LPA's ) Thompson and Silva conducted an unannounced case management visit as a result of reviewing files for an unannounced complaint visit. LPA met with Director Saeideh Gharavi. LPA toured the facility inside and outside. While touring the outside play area, LPA observed 2 staff along with 10 preschool age children and 1 staff inside with 2 preschool age children.

During the inspection, a review of the Facility Personnel Report Summary on this date indicates not all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Staff (S1) stated, she has been employed at the center for 3 months and is working through an agency called Childcare Career Center (CCC). When LPA requested S1 file, Director stated she would email the file. LPA observed S1 was not associated to the facility.

Director 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 provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian


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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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: MILESTONES ACADEMY CHILDCARE CENTER, INC.
FACILITY NUMBER: 304371099
VISIT DATE: 01/25/2023
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In the areas that were evaluated, one Type A 101170(e) Criminal Record Clearance citation was observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.


LPA Thompson informed Director Saeideh Gharvi that this report dated 1/25/2023 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed the Director Saeideh Gharvi to provide a copy of this licensing report dated 1/25/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Director Saeideh Gharvia. A notice of site visit was given and must remain posted for 30 days.



Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their 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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/25/2023 02:54 PM - It Cannot Be Edited


Created By: Dean Thompson On 01/25/2023 at 10:38 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: MILESTONES ACADEMY CHILDCARE CENTER, INC.
FACILITY NUMBER: 304371099

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
01/25/2023
Section Cited
HSC
101170(e)

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101170 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
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LPA observed S1 leave the facility at the time of visit.
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Staff (S1) stated, she has been employed at the center for 3 months and is working through an agency called Childcare Career Center (CCC). When LPA requested S1 file, Director stated she would email the file. LPA observed S1 was not associated to the facility.
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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:Judy Hanson
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023


LIC809 (FAS) - (06/04)
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