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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370816
Report Date: 12/09/2025
Date Signed: 12/09/2025 03:13:49 PM

Document Has Been Signed on 12/09/2025 03:13 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:KIDS KASTLE PRESCHOOLFACILITY NUMBER:
304370816
ADMINISTRATOR/
DIRECTOR:		BEDFORD, KATIEFACILITY TYPE:
830
ADDRESS:2525 FAIRVIEW ROADTELEPHONE:
(714) 437-1720
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 19DATE:
12/09/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:03 PM
MET WITH:Facility Representative/Asst. Dir., Kristine FernandezTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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In conjunction with another inspection on 12/09/2025, Licensing Program Analyst (LPA) Deschampe conducted a case management inspection. At 9:03 AM, LPA entered the facility via an unlocked security gate. LPA met with Facility Representative/Assistant Director, Kristine Fernandez and explained the purpose of the visit. Total census was 19 infants with 6 staff.

A review of the Facility Personnel Report Summary on this date, 12/09/2025 indicates all facility staff and other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

California Code of Regulations (CCR) Section 101429 Responsibility for Providing Care and Supervision for Infants (a) In addition to Section 101229, the following shall apply: (1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. At approximately 10:00 AM, LPA and FR exited the hallway of the classroom building and observed an infant, Child 1 (C1) near the facility office, at the back gate entrance to the church grounds/staff break area. There was 11 infants (under 24 months) and 4 staff were observed in the outdoor infant play area, towards the preschool playground and climbing equipment (plastic tree). The closest staff was approximately 38 feet from C1. FR immediately walked with C1 to the closest staff, Staff 1 (S1). S1 stated another staff member had walked out to go on break and C1 followed. FR immediately reminded all infant staff to count infants regularly in order to maintain visual supervision at all times. This poses as an immediate Health, Safety, or Personal Rights risk to persons in care.

CCR Section 101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. At 9:03 AM, while LPA was walking toward the security gate a parent with 2 children entered the facility but the security

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2025
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: KIDS KASTLE PRESCHOOL
FACILITY NUMBER: 304370816
VISIT DATE: 12/09/2025
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gate did not latch. Approximately 20 seconds later, LPA arrived at the security which was not locked and LPA entered the facility without entering the security gate code. This LPA informed the FR who immediately sent all parents a text message via ProCare regarding the matter. This poses as a potential Health, Safety, or Personal Rights risk to persons in care if left unaddressed.

LPA informed FR to provide a copy of this licensing report dated 12/09/2025 that documents any Type A citation to parents/authorized representatives 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/authorized representatives 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.

After the inspection, the following deficiencies were observed and are being cited on the attached LIC 809-D and LIC 9102 in accordance with California Code of Regulations (CCR) Title 22 Division 12 Chapter 3:

CCR Section 101429(a) Responsibility for Providing Care and Supervision for Infants (LIC809-D)

CCR Section 101238(a) Buildings and Grounds (LIC 9102)

Exit interview conducted and report was reviewed with the facility representative/assistant director, Kristine Fernandez. Appeal Rights were discussed with facility representative. The facility representative was provided a copy of the 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. A notice of site visit was given and must remain posted for 30 consecutive days. The “Notice of Site Visit” must be posted on, or immediately adjacent to, the interior side of the main door to the facility. Failure to post will result in Civil Penalties of $100.00.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/09/2025 03:13 PM - It Cannot Be Edited


Created By: Susan Deschampe On 12/09/2025 at 02:27 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: KIDS KASTLE PRESCHOOL
FACILITY NUMBER: 304370816

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/09/2025
Section Cited
CCR
101429(a)(1)

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Responsibility for Providing Care and Supervision for Infants (a)(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.

This requirement is not met as evidenced by:
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FR immediately brought Child 1 to staff.
FR immediately reminded staff to consistently complete head count of children.
FR to have staff read and sign regulation.
FR will form groups 1:4 for outdoor play to better maintain visual supervision.
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Approximately 10:00 AM, FR and LPA observed Child 1 alone, with staff approximately 38 feet away with play equipment blocking visual supervision.
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FR to have authorized representative (AR) to review 809 & sign LIC9224 within 24 hours.
FR to give new ARs the 809 & sign LIC 9224

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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:
Susan Deschampe
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2025


LIC809 (FAS) - (06/04)
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