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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270029
Report Date: 03/20/2025
Date Signed: 03/24/2025 08:00:56 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/10/2025 and conducted by Evaluator Soo Jin Jung
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250210132328
FACILITY NAME:CAPO BEACH CHURCH PRESCHOOLFACILITY NUMBER:
304270029
ADMINISTRATOR:PENUELAS, MAGGIEFACILITY TYPE:
850
ADDRESS:25975 DOMINGO AVE. RMS.7,8,9TELEPHONE:
(949) 443-1316
CITY:CAPISTRANO BEACHSTATE: CAZIP CODE:
92624
CAPACITY:50CENSUS: 22DATE:
03/20/2025
UNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Director, Jordan WolfTIME COMPLETED:
10:10 AM
ALLEGATION(S):
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Staff do not prevent day care children from being injured by another child in care
Staff did not report injuries to child's authorized representative
INVESTIGATION FINDINGS:
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On 3/20/2025, Licensing Program Analyst (LPA), Christine Jung, conducted an unannounced visit to the facility to deliver findings for a complaint that was received at the Orange County Regional Child Care Licensing Office. LPA met with Director, Jordan Wolf and explained the reason for the visit. LPA was led on a tour of the facility and observed a total of 22 children and two (2) staff.

A review of the Facility Personnel Report Summary on this date 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 inspection the facility was operating within its licensed capacity and within compliance of staffing ratios.

(Go to Page 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 06-CC-20250210132328
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CAPO BEACH CHURCH PRESCHOOL
FACILITY NUMBER: 304270029
VISIT DATE: 03/20/2025
NARRATIVE
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(Page 2)
On 2/10/2025, the Orange County Regional Child Care Licensing Office received a complaint with two allegations listed above: Reporting Party (RP) alleged that (1) staff do not prevent day care children from being injured by another child in care and (2) staff did not report injuries to child's authorized representative.

On 2/11/2025, LPA made an unannounced visit to the facility and interviewed four (4) staff and six (6) children. All staff interviewed stated that the facility has taken steps to prevent injuries occurring between children in care. Director provided LPA with portion of parent handbook regarding behavioral expectations, staff roster, children’s roster, and additional documents for investigative review.

All staff interviewed stated that they are providing close supervision, positive reinforcement, and keeping separate those children who have reoccurring incidents with one another. If necessary, facility reassigns children to different classrooms. All staff interviewed also confirmed that incidents, including injuries, have been reported to children’s authorized representatives by means of incident reports and/or emails.

All children interviewed stated that they are not supposed to hurt other children, and if they did, their teachers would direct them to discontinue those behaviors. All children stated that if they incur any injuries, they would ask their teachers for assistance.

LPA interviewed four (4) parents. Two (2) parents who were also contacted could not be reached. All four (4) parents interviewed stated that they are happy with the facility and receive communication from the facility regarding incidents with their children.

Based on LPA’s record reviews, LPA was able to confirm that the facility has been communicating with authorized representatives regarding incidents that occur at the facility. LPA reviewed text messages, incident reports, and emails exchanged between the facility, staff, and authorized representatives. These documents showed that the facility has been collaborating with authorized representatives to prevent day care children from injuring each other.

(Go to Page 3)
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20250210132328
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CAPO BEACH CHURCH PRESCHOOL
FACILITY NUMBER: 304270029
VISIT DATE: 03/20/2025
NARRATIVE
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(Page 3)
The Orange County Regional Child Care Licensing Office has investigated the complaint alleging (1) staff do not prevent day care children from being injured by another child in care and (2) staff did not report injuries to child's authorized representative. Although the allegations may have happened or are valid, there was not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Jordan Wolf.

End of report.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3