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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371704
Report Date: 08/22/2024
Date Signed: 08/22/2024 03:00:45 PM

Document Has Been Signed on 08/22/2024 03:00 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GIVINGTREE MONTESSORIFACILITY NUMBER:
304371704
ADMINISTRATOR/
DIRECTOR:		SOOYOUNG SHINFACILITY TYPE:
860
ADDRESS:1901 NORTH EUCLID STREETTELEPHONE:
(714) 336-2872
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: DATE:
08/22/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Seong Mi Son, Board of Director of H&S GlobalTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts (LPAS) P Rivas and R Castanon conducted an office meeting with Ms. Son and Jeanie Yu, Employee. FOCUS Interpreter Services were used with interpreter #56488289 .
LPAs discussed incomplete and incorrect information on lic200a and lic 999 and advised that Board resolution is needed.
LPAs discussed corrrect applicant and Ms. Son affirmed Ms. Sooyoung Shin will be the designated applicant and Director. LPA advised Ms. Son that she will no longer be able to speak about application with her but only with Ms. Shin.
LPAs discussed Lic 200a was listed as a new application and not a relocation. LPA verified with Ms. Son this is a relocation from 304371291 Givingtree Montessori. Applicant is to correct information.
LPAs discussed various forms but advised this is not a complete review of the application.
LPAs advised a fire clearance will be sent as soon as the lic 200a and lic 999 are received.
A notice of incomplete application will be submitted to Ms.Shin after a review of the application is made.

An exit interview conducted.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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