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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371171
Report Date: 12/04/2023
Date Signed: 12/21/2023 08:53:57 AM

Document Has Been Signed on 12/21/2023 08:53 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:VILLAGE PRESCHOOL ACADEMYFACILITY NUMBER:
304371171
ADMINISTRATOR:VILLANUEVA DIAZ, KARENFACILITY TYPE:
830
ADDRESS:18052 IMPERIAL HWYTELEPHONE:
(714) 993-3444
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/04/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Director Karen Villanueva DiazTIME COMPLETED:
01:00 PM
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On 12/04/23, Licensing Program Analyst (LPA), Anna Chan conducted an unannounced onsite inspection for the purpose of an Annual Random Visit. LPA met with Assistant Director Jenna Matthews. At 8:40am LPA and Assistant director toured the facility inside and outside and the floor and yard plan were verified. Census was taken, the overall census observed was 9 infants and 3 staff in the Infant Room. Infants are having indoor circle time activity seated in the highchair attached to the table which holds 6 infants. Director, Karen Villanueva Diaz arrived 10 minutes later at around 8:50am. The infant room is located on the left side of the facility detached from the main building when facing the building from the parking.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 6:30a.m.- 6:00p.m., Monday through Friday. A review of the Facility Personnel Report Summary 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.

During today’s observation, the changing room in the infant room is not within arms reach of the sink. There is a sink in the restroom and in the nap room. The food preparation area such as microwave and fridge is inside the restroom.

Due to system issues, this visit will continue at a later date. If any deficiencies are observed, disclosed, or discovered during today’s visit, they will be addressed and cited at a later date.

End of Report
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2023
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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