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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371099
Report Date: 06/10/2024
Date Signed: 06/12/2024 11:50:23 AM

Document Has Been Signed on 06/12/2024 11:50 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:MILESTONES ACADEMY CHILDCARE CENTER, INC.FACILITY NUMBER:
304371099
ADMINISTRATOR/
DIRECTOR:		GHARAVI, SAEIDEHFACILITY TYPE:
850
ADDRESS:23184 EL TORO FRONTAGE ROADTELEPHONE:
(949) 588-7000
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 19DATE:
06/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Saeideh GharaviTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On 6/10/24, Licensing Program Analysts (LPA), Christine Jung and Nguyen Tran, conducted an onsite inspection for the purpose of an Annual Inspection. Upon arrival, LPAs were led on a tour by Director Saeideh Gharavi. The overall census observed was 3 preschool staff, 12 preschool children including 4 toddlers. Facility hours are 7:00 a.m.- 6:00 p.m., Monday through Friday.

The Facility Personnel Report Summary reviewed on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During the inspection, items which could pose a danger to children detergents, cleaning compounds, and medications were observed to be inaccessible to children. Poisons/Hazardous Items were not observed on the premises. Food is prepared on site; breakfast, lunch, and snacks are provided. Food prep areas were clean and sanitary; food was properly stored. Menus were posted where they could be reviewed by authorized representatives. Floors, equipment, and furniture were clean, observed to be in good repair, and free of sharp edges. There was drinking water available, both indoors and outdoors, to children by refillable bottles labeled with the children’s names. The children's restrooms were clean and sanitary. Children nap on cots and bedding was stored individually. Blankets are taken home weekly to be washed by parents, sheets are washed by the facility weekly. The facility conducted a fire/earthquake emergency drill on 5/2/24. The facility had a working carbon monoxide detector. Facility met all posting requirements.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE: DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2024
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 6
Document Has Been Signed on 06/12/2024 11:50 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 06/10/2024 at 03:08 PM
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: 06/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that 2 out of 2 staff did not have current Mandated Reporter Training certificates, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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Director stated that they will submit updated Mandated Reporter Training certificates to the LPA by the due date.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that 2 out of 2 staff did not have health screenings on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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Director stated that they will submit updated health screenings for staff to the LPA by the due date.
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:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2024


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Page: 2 of 6
Document Has Been Signed on 06/12/2024 11:50 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 06/10/2024 at 03:08 PM
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: 06/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(b)(2)
Child's Medical Assessments
(b) The medical assessment shall provide the following: (2) Results of a test for tuberculosis.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that 1 out of 1 child did not have a Physician's Report and TB result on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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The director stated that they will submit a physician's report and TB test result for Child 1 (C1) to LPA by due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2024


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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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MILESTONES ACADEMY CHILDCARE CENTER, INC.
FACILITY NUMBER: 304371099
VISIT DATE: 06/10/2024
NARRATIVE
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*This is an amended version of the original report dated 6/10/24.*
Staff files were reviewed for all staff present on this date. There was a separate record for each staff, but 1 out 3 staff did not have current Mandated Reporter Training certificates and 1 out 3 staff did not have the Health Screening form on file.

Children’s files were reviewed. There was a separate record for each child, but 1 out 6 children did not have Physician’s Reports on file. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of day.

The outdoor activity space was inspected for compliance and was enclosed by a fence. The surface of the outdoor activity space was maintained and free of hazards. The cushioning material rubber mats and artificial grass around the climbing equipment, slides, and other similar equipment was sufficient to absorb falls. The outdoor equipment and toys were in good repair. Director stated there are no bodies of water present at the facility. During today’s visit, LPAs inspected the newly installed play structure. The structure included a slide, rock climbing wall, and steps. The structure met age appropriate standards as stated on manufacturing sticker on the structure. The director stated that they will ensure supervision of the children at all times. The playground was measured. The total outdoor space measured a total of 3,233 sq ft. which is sufficient for 43 preschool children. Director was informed of the maximum allowed children to be on the playground at any given time. Children in the toddler program shall use the separate toddler playground.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MILESTONES ACADEMY CHILDCARE CENTER, INC.
FACILITY NUMBER: 304371099
VISIT DATE: 06/10/2024
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Based on LPAs observations, record reviews, and interviews, the following violations were observed and are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1. See LIC 809D for violations cited: 3 Type B.

A notice of site visit was given and must remain posted for 30 days. Failure to post will result in a Civil Penalty of $100.00.

Exit interview conducted and report was reviewed with the licensee Saeideh Gharavi.

End of Report.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2024
LIC809 (FAS) - (06/04)
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