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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370262
Report Date: 04/14/2026
Date Signed: 04/14/2026 12:55:19 PM

Document Has Been Signed on 04/14/2026 12:55 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:HBCSD-PRESCHOOL ACADEMYFACILITY NUMBER:
304370262
ADMINISTRATOR/
DIRECTOR:		NGUYEN, ROCHELLEFACILITY TYPE:
850
ADDRESS:19231 HARDING LANETELEPHONE:
(714) 378-2033
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY: 124TOTAL ENROLLED CHILDREN: 124CENSUS: 24DATE:
04/14/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:DirectorTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite case management inspection of this facility for the purpose of investigating an incident that the facility self reported to our office on 4/2/2026. LPA met with director, Rochelle Nguyen. The normal drop in time is at 9:00 am. Upon arrival, LPA inspected all the classrooms (1, 2, 3, 4, 5, 6, 7, 12, 13, ). Rooms 9, 10, 34, and 36 were not currently in use. Census was taken. 8 children with 3 staff in room 1, 11 children with 3 staff in Room 2, and 6 children with 3 staff in Room 4 observed. More parents were signing their children in during LPA's inspection. More staff arrived too.
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. The staff are exempt from the above requirement because they are employed with Huntington Beach City School District (HBCSD)

According to the self reported incident, on 4/1/2026 a 2 year old child # 1 (C1) was found unattended in Room 2 by Adult #1 (A1) during transitioning from Room 2 to Room 6 for an art activity in the morning at 10:30am . According to the incident report C1 must have been left unattended in Room 2 for approximately 15 minutes.

Today LPA interviewed the staff who were involved in the above reported incident. Staff # 1(S1, S2, and S3). LPA obtained additional information from S4, and S5 as well. C1 was not interviewed due to their age being too young. Continued on page 2
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: HBCSD-PRESCHOOL ACADEMY
FACILITY NUMBER: 304370262
VISIT DATE: 04/14/2026
NARRATIVE
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During interviews with staff, they stated the following:
S1 stated they normally count children before transitioning, unfortunately on the day of incident S1 did not have time to count children because they were in a hurry to leave Room 2 and not to be late for the Art Activity in Room 6. S1 estimates C1 must have left unattended for approximately 15 minutes in Room 2.
S2 stated they normally count children in the classroom and write the final count on the white board in the classroom. S2 stated there were 17 children with 3 staff on the day of the incident. S2 stated S2 was distracted by talking to S6 during transiting. S2 stated S2 did not remember seeing C1 in the classroom or during transiting. S2 assuming C1 was playing by the doll house while sitting because that area was C1's favorite spot. S2 stated C1 must have been left unattended in Room 2 for 15 minutes because that was the time one of the staff took their 15 minutes break and the incident happened during the absence of the staff member.
S3 stated S3 always counts the children out of habit. S3 remembers there was 17 children was written on the white board when S3 entered Room 2. S3 stated S3 did not count the children when they were in Art Room (Room 6). S3 believes C1 must have left unattended for approximately 15 minutes.
S4 provided additional documents to LPA.
S5 stated S5 observed on the recorded video footage that children and staff left Room 2 at 10:12 am and A1 went to Room 2 and found C1 at 10:30 am.(The video footage was not available for LPA to review).
Based on the self reported incident, and admission of the three staffs' interviews today, obtaining additional documents from S4, and S5's observation of video footage, it was determined that the facility was in violation of Lack of Supervision of children. C1 was left unattended between 10:12 to 10:30 am in Room 2.
Please refer to the following deficiency which was cited on the next page (LIC809D).

LPA Malek informed the director, Rochelle Nguyen that this report dated 4/14/26 documents type A citation shall be posted for 30 consecutive days as there is immediate risk to the health, and safety of children in care. Also, LPA Malek informed the director, Rochelle Nguyen to provide a copy of this licensing report dated 4/14/26 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.


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the director, Rochelle Nguyen. End of report.
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/14/2026 12:55 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 04/14/2026 at 12:10 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: HBCSD-PRESCHOOL ACADEMY
FACILITY NUMBER: 304370262

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/15/2026
Section Cited
CCR
101229(a)(1)

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Responsibility for Care and Supervision-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. The above requirement was not met as evidenced by:
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Director stated she will discuss the issue with all staff. A review of supervision discussion with the staff will be sent to our office by the due date. The training shall contain supervision of children at all times specially during transitioning (before and after) from one to another or to the playground.
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a self reported incident, and admission of the three staffs' interviews today, and S5's observation of video footage, and obtaining additional documents from S6, that C1 was left unattended between 10:12 to 10:30 am in Room 2. This is an immediate risk to the health and safety of children in care.
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 Supervision shall include visual observation. The statement with the staffs' signatures acknowledging the importance of supervision and conducting accurate counts of children procedure will be sent to our office by the due date of 4/15/2026.

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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: 04/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2026


LIC809 (FAS) - (06/04)
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