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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371512
Report Date: 05/16/2023
Date Signed: 05/16/2023 12:51:21 PM

Document Has Been Signed on 05/16/2023 12:51 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:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
304371512
ADMINISTRATOR:LAURA G JOHNSONFACILITY TYPE:
850
ADDRESS:21772 LAKE FOREST DRIVETELEPHONE:
(949) 859-0805
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 141TOTAL ENROLLED CHILDREN: 71CENSUS: 49DATE:
05/16/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:03 AM
MET WITH:Laura JohnsonTIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 5/5/2023. LPA met with Director Laura Johnson. LPA observed 49 preschool age children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 5/5/2023 a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported a parent called sheriff to report an alleged physical contact (shaking) that occurred at Children's Courtyard between her child #1 (C1) and staff #1 (S1).

During today’s visit, LPA obtained an updated copy of the children’s roster, obtained children and staff files, interviewed director, and S1. Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Director Laura Johnson was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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