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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370547
Report Date: 09/17/2025
Date Signed: 09/17/2025 10:59:23 AM

Document Has Been Signed on 09/17/2025 10:59 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAMFACILITY NUMBER:
304370547
ADMINISTRATOR/
DIRECTOR:		MEDRANO, PATRICIAFACILITY TYPE:
850
ADDRESS:1405 FRENCH STREETTELEPHONE:
(714) 564-2200
CITY:SANTA ANASTATE: CAZIP CODE:
92701
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 19DATE:
09/17/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Early Learning Specialist; Laura Barnett TIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA) Cynthia Sun conducted an unannounced follow-up case management inspection in response to a self-report Unusual Incident dated 07/23/25. LPA met with Early Learning Specialist, Laura Barnett and informed the purpose of today’s case management initiated on 07/29/2025. The census was taken as follows: 6 staff supervising, 19 preschool children in Rooms #30 and #31.

A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal records and child abuse index clearances or exemptions.

The Regional office received an Unusual Incident Report (UIR) on 07/23/2025. UIR was reported by Early Learning Specialist, Laura Barnett. According to Early Learning Specialist, Barnett on 07/22/25, approximately 3:30 PM Parent #1 (P1) stated that Child #1 (C1) had signs of sexual abuse and P1 took C1 to Children’s Hospital of Orange County (CHOC). The medical documentation P1 received stated the reason for C1’s hospital visit was because P1 suspected sexual abuse. C1 did not state that C1 had been touched by anyone at school. P1 provided the facility with documentation confirming that C1 received a forensic exam. P1 stated C1 only went to CHOC Children’s Hospital. P1 stated C1 told P1 Staff #2 (S2) squeezed C1’s right arm when S2 took a toy away from C1. P1 stated C1 did not make any allegations regarding being sexually abused.

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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Cynthia Sun
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2025
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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SAUSD/DAVIS ELEM. SCHOOL-KINDER READINESS PROGRAM
FACILITY NUMBER: 304370547
VISIT DATE: 09/17/2025
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LPA interviewed (P1) who stated (C1) doesn’t like to be touched or hugged by anyone. P1 also stated C1 doesn’t like to go to the bathroom with anyone except with P1. P1 stated P1 took C1 to the doctor and the doctor diagnosed possible C1 abused that C1 had inflamed vulva, no penetration. LPA asked P1 if child has been left with any adults aside from school staff and P1 stated P1 doesn’t leave C1 alone or with anyone. P1 stated when C1 is not in school, P1 takes C1 to work with P1.

On 07/29/2025, LPA interviewed Staff #1, (S1) stated staff supervise children, take children in small groups to restroom, make sure children use bathroom and make sure children are not playing in restroom, clothes are clean, child washes hands, staff wait for all the children to finish in the restroom. LPA asked S1 if staff help children that are considered fully potty trained. S1 stated S1 makes sure children have wipes. If the child is soiled, S1 put soiled clothes in a bag and make sure children wash their hands; this is all verbal. S1 tries to only have a few children in bathroom so S1 can see all the children.

2 out of 2 staff stated sometimes staff need to take children to the restroom alone and this is part of their procedure due to classroom ratio. 2 out of 2 staff stated they have not seen any adults handling children in an unusual manner. c

LPA attempted to interview 5 children and was only able to interview 1 child. Child #2 (C2) stated S2 is C2’s friend. S2 helps C2 when C2 gets hurt, and S2 is nice to C2.

LPA reviewed Children’s Hospital medical documentation that stated discharge diagnosis: vaginitis; constipation; parental concern about possible child sexual abuse.

Based on LPA’s interviews and record review, there was no evidence to support the parent’s disclosure. The facility was in compliance with regulations and no deficiency was observed.

Exit interview conducted and report was reviewed with Licensee Notice of Site Visit was posted and must remain posted for 30 days. Failure to comply with the posting requirements shall result in an immediate civil penalty of $100.

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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Cynthia Sun
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC809 (FAS) - (06/04)
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