<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371512
Report Date: 09/10/2024
Date Signed: 09/10/2024 12:45:22 PM

Document Has Been Signed on 09/10/2024 12:45 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:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
304371512
ADMINISTRATOR/
DIRECTOR:		JOHNSON, LAURA G.FACILITY TYPE:
850
ADDRESS:21772 LAKE FOREST DRIVETELEPHONE:
(949) 859-0805
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 141TOTAL ENROLLED CHILDREN: 133CENSUS: 72DATE:
09/10/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Director, Laura (Gabby) JohnsonTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Nguyen and Meza conducted an unannounced case management inspection due to deficiencies discovered during staff interviews on 08/05/2024. Upon arrival LPAs met with Director, Laura (Gabby) Johnson, who accompanied LPAs on a tour of the facility. Census was taken as follow: 6 toddlers, 66 preschool children with 8 staff members. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

On 08/05/2024, during an inspection to the facility, and interviews with the staff, it was discovered that the facility did not report an unusual incident LIC624 to the Department. Staff #1 (S1) and Staff #2 (S2) stated they were aware a child abuse case was made, however S1 and S2 didn’t know they were required to report the incident to the Community Care Licensing Department.

Based on the interviews conducted with staff members, the following deficiency is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101212(d)(1)(D) Reporting Requirement. The deficiency is being cited on the attached 809D.

Exit interview was conducted with Director, Laura (Gabby) Johnson. The Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. The Director was provided with a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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 2
Document Has Been Signed on 09/10/2024 12:45 PM - It Cannot Be Edited


Created By: Cindy Nguyen On 09/10/2024 at 12:06 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: CHILDREN'S COURTYARD, THE
FACILITY NUMBER: 304371512

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
101212(d)(1)(D)

1
2
3
4
5
6
7
101212 Reporting Requirements (d) Upon the occurrence...during its normal business hours.... (d)(2) below shall be submitted to the Dept within seven days... (1) Events reported... (D) Any suspected physical or psychological abuse of any child. This requirement is not meet by:
1
2
3
4
5
6
7
Director stated they will make sure they report any unusual incident within 24 hours via phone call and submit a written incident report within 7 days. Director submitted LIC624 unusual incident report for this incident on 09/17/2024.
8
9
10
11
12
13
14
Based on interviews conducted by LPA Nguyen, it was determined that the facility did not report the child abuse report to licensing. This is a potential Health and Safety risk to the children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Patricia Magana
LICENSING EVALUATOR NAME:Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2