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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371247
Report Date: 02/17/2022
Date Signed: 02/17/2022 03:23:55 PM

Document Has Been Signed on 02/17/2022 03:23 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:MILESTONES MONTESSORI OF LAKE FORESTFACILITY NUMBER:
304371247
ADMINISTRATOR:PATOPOFF, JAMIEFACILITY TYPE:
850
ADDRESS:23222 LAKE CENTER DRIVETELEPHONE:
(949) 830-9999
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 194TOTAL ENROLLED CHILDREN: 194CENSUS: 101DATE:
02/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Ms. Patopoff, Jamie TIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Desai, Ketki conducted an unannounced Case Management Licensee initiated inspection at the above facility for the purpose of adding room # 106 (Red room), removing previously licensed room # 107 and decreasing the Preschool capacity from 170 children to 165 children with 24 Toddler option children (18 to 36 months in one Purple room #101) .

Currently facility is licensed for 170 preschool age children (2-6 years) in 5 rooms and 24 Toddler option in one Purple room # 101.

Facility is now requesting to add room # 106 (Red room), and removing previously licensed Room # 107 from the Preschool License.

Facility Director Ms. Patopoff, Jamie gave a tour of the facility and the rooms were measured.

The following was observed in new Preschool room # 106 (Red room)
· Age appropriate furniture and equipment’s
· Indoor toys and activity items
· Room is well lighted with ventilation.
· Drinking water is available through water fountain and personal water bottles
· Electronic sign in and out (Pro- Care application)
· CDC Guidelines are being followed.
· There are 2 sinks and 2 toilets inside the classrooms

Total indoor space for Preschool: 5771’63 divided by 35 = 164’90 (165 children)
(Page-1)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MILESTONES MONTESSORI OF LAKE FOREST
FACILITY NUMBER: 304371247
VISIT DATE: 02/17/2022
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Sinks: 11 x15= 165 children
Toilets: 15x 15= 225 children.

Outdoor space: Playground is completely enclosed by a fence. It has age appropriate climbing structures, bike trail and sandbox area. There is an open space called as Play area in front of the lobby.

Total outdoor activity space: 18691’68 divided by 75 = 249’22 (249 children)

Based on today’s Indoor and Outdoor measurements, sink & toilet availability, center has enough activity space to support the requested capacity of 165 Preschool age children in the five preschool rooms as follows Blue Room # 102 / Green room # 103 / Yellow room # 104/ Green room # 105 and Red room # 106 .

Toddler Option

Facility has Toddler option attached to the Preschool license with a capacity of 24 toddlers.
Toddlers are in Room # 101 (Purple room)

The indoor activity space in Toddler room: 906’03 divided by 35 = 35’89 (26 Children)

The Outdoor activity space for Toddlers: Toddler option has their own assigned yards, separate from other yards.
Outdoor activity space: 1387’00 divided by 75= 18’49 (18 children)
Facility shall request a Waiver to accommodate the 24 Toddlers in the out door yard on a rotating schedule.

There are 2 sinks and 2 Toilets in the Toddler room # 101

Fire clearance approval has been received from Orange county Fire Authority approving the capacity of 213 children (165 Preschool / 24 Toddlers and 24 Infants).
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MILESTONES MONTESSORI OF LAKE FOREST
FACILITY NUMBER: 304371247
VISIT DATE: 02/17/2022
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License for 165 Preschool age children (2-6 years) in Blue Room # 102 / Green room # 103 / Yellow room # 104/ Green room # 105 and Red room # 106 .
24 Toddlers (18-36 months) in Purple Room # 101 and Infants (4 months to 24 months) in Pink room # 100
Monday to Friday 7:00 AM to 6:00PM

Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post it will result in civil penalties of $100.

Appeal rights presented to the Director.

Exit interview conducted.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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