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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371428
Report Date: 07/17/2023
Date Signed: 07/19/2023 10:50:17 AM

Document Has Been Signed on 07/19/2023 10:50 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MILESTONES ACADEMY CHILDCARE CENTER, INC.FACILITY NUMBER:
304371428
ADMINISTRATOR:GHARAVI, SAEIDEHFACILITY TYPE:
830
ADDRESS:23184 B EL TORO FRONTAGE ROADTELEPHONE:
(949) 588-7000
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 20TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
07/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Saeideh GharviaTIME COMPLETED:
11:10 AM
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A Case Management inspection conducted on this by Licensing Program Analyst (LPA) Dean Thompson to issue an amended LIC 9099 report, update the LIC 9099D page dated 01/25/2023, and obtain signatures. LPA met with Director Saeideh Gharvia. LPA observed 8 infant children in care along with 3 infant staff.

Please see "Amended" LIC 9099 report dated 01/25/2023 and updated LIC 9099 D page for correction.

Exit interview was conducted.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2023
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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