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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300603894
Report Date: 07/21/2025
Date Signed: 07/21/2025 03:55:21 PM

Document Has Been Signed on 07/21/2025 03:55 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:ANNELIESE'S PRESCHOOL INCORPORATED AT ALISOFACILITY NUMBER:
300603894
ADMINISTRATOR/
DIRECTOR:		SCHULZ, MONICAFACILITY TYPE:
850
ADDRESS:21542 WESLEY DRIVETELEPHONE:
(949) 499-5527
CITY:LAGUNA BEACHSTATE: CAZIP CODE:
92651
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 30DATE:
07/21/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite case management inspection for the purpose of investigating an incident that the facility self reported to our office on 7/14/2025.
LPA met with administrator, Maureen Redding. The new director, Tammy Keces was not present. However, LPA spoke with her over the phone. Census was taken. There was a total of 30 napping preschool children with 4 staff. 12 napping children with 2 staff in one room, and 18 napping preschool children with 2 staff in another room observed. Four other classrooms were not in use. According to the self-incident report, on 7/10/2025, Staff # 1 (S1) was outside with ten children. S1 assumed all the children were picked up from school. About 10 to 15 minutes later the parent of Child # 1 (C1) found C1 on the playground alone. Staff were unaware until the parent notified S1.
A review of the Facility Personnel Report Summary on this date indicates all facility who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Today, LPA gathered information from the staff who had knowledge regarding the incident. LPA reviewed the sign in and out sheet for children dated July 10, 2025. LPA also reviewed the time cards for staff dated July 10, 2025. Based on the information received. S1, S2, and S3 were present at the facility towards the closing time at 5:00 pm. S1 had between 7 to 10 children on the playground towards the end. S2 was busy conducting closing duties, which included checking classrooms and locking doors. S3 was not with children. S1 who was supervising children, started transitioning children from the playground to the patio for reading activity around 4:45 pm not realizing 2 year old C1 has been left on the playground and not present in the group of children on the patio at the reading table. S2 notified S1 that all the procedure for closing was
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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ANNELIESE'S PRESCHOOL INCORPORATED AT ALISO
FACILITY NUMBER: 300603894
VISIT DATE: 07/21/2025
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completed. S1 was observed to have one child left at this time. However, C1 was still on the playground unnoticed. S1 failed to head count children during transitioning from playground to patio as it was required.


Last child left at 4:55 pm. According to the information gathered S1, S2, and S3 started leaving the campus at 5:06 pm. At 5:07 pm, C1's representative arrived at the gate to pick up C1. C1 was found on the playground unsupervised. There is no accurate time to determine how long the child has been left unattended. However, it is estimated that the child was unsupervised on the playground for approximately 10 to 15 minutes.

Today, LPA was notified that an updated daily checklist during transitions, opening, and closing times has been reviewed with staff.

Based on the self reported incident, staffs' interviews, and reviewing documents related to the incident, it was determined the facility failed to provide visual supervision of a 2 year old child in care, therefore, California Code of Regulations, Title 22, Division 12, Section 101229(a)(1)- Responsibility for Providing Care and Supervision is being cited on the attached LIC 809D.

The facility representative, Maureen Redding was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalty of $100.00. LPA Malek informed the facility representative, Maureen Redding that this report dated 7/21/2025 documents type A citation shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care. Also, LPA Malek informed the facility representative, Maureen Redding to provide a copy of this licensing report dated 7/21/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.


A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. The facility representative, Maureen Redding was provided with a copy of their appeal rights (LIC 9058) 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. The exit interview was conducted with the facility representative, Maureen Redding.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/21/2025 03:55 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 07/21/2025 at 03:17 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: ANNELIESE'S PRESCHOOL INCORPORATED AT ALISO
FACILITY NUMBER: 300603894

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2025
Section Cited
CCR
101229(a)(1)

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(a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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The facility representative agreed to send a statement with staff signatures acknowledging understanding the importance of supervising children at all times. Also, the facility representative will review the procedure of name to face during transitioning procedures
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This requirement was not met as evidenced by a self-report incident, staffs interviews, and reviewing documents, 2 year old child was left unattended on the playground during transitioning from playground to patio on 7/10/2025 for approximately 10 to 15 minutes. This is an immediate risk to the health and safety of children in care.
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with all staff. The statement will be send to LPA's email address by the due date of 7/22/2025.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Thuy Ho
NAME OF LICENSING PROGRAM MANAGER:
Mahnaz Malek
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2025


LIC809 (FAS) - (06/04)
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