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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
304314435
Report Date:
12/11/2024
Date Signed:
09/02/2025 09:44:49 AM
Document Has Been Signed on
09/02/2025 09:44 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
,
750 THE CITY DRIVE, SUITE 250
ORANGE
,
CA
92868
FACILITY NAME:
AGUIRRE, TRISHA
FACILITY NUMBER:
304314435
ADMINISTRATOR/
DIRECTOR:
AGUIRRE, TRISHA
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(949) 632-2400
CITY:
LAKE FOREST
STATE:
CA
ZIP CODE:
92630
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
DATE:
12/11/2024
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
10:23 AM
MET WITH:
TIME VISIT/
INSPECTION COMPLETED:
10:24 AM
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NAME OF LICENSING PROGRAM MANAGER:
Martha Malane
NAME OF LICENSING PROGRAM ANALYST:
Soo Jin Jung
LICENSING PROGRAM ANALYST SIGNATURE:
DATE:
12/11/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/11/2024
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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