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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312940
Report Date: 11/27/2024
Date Signed: 11/27/2024 02:03:14 PM

Document Has Been Signed on 11/27/2024 02:03 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:SONEJI, MAYURIFACILITY NUMBER:
304312940
ADMINISTRATOR/
DIRECTOR:
SONEJI, MAYURIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 552-5763
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Licensee, Mayuri SonejiTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 11/27/24, Licensing Program Analyst (LPA) Cynthia Sun conducted a case management visit for the purpose to interview staff and children to ensure compliance with regulations in regard to Care and Supervision, Personal Rights, and Staffing Ratio and Capacity. Upon arrival LPA met with licensee, Mayuri Soneji who stated there were no children present due to the Thanksgiving Holidays. LPA confirmed there were no children present during today’s visit.

A review of the Facility Personnel Report Summary on 11/27/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today's visit, LPA interviewed licensee and assistant #1(A1). LPA also obtained the facility roster.

The department will continue conducting additional interviews to determine compliance.

Exit interview conducted and report was reviewed with licensee Mayuri Soneji. The Notice of Site Visit was posted and must be posted for 30 days. Failure to comply with the posting requirements will result in an immediate civil penalty of $100.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

End of Report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2024
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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