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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370986
Report Date: 10/27/2025
Date Signed: 10/27/2025 05:16:55 PM

Document Has Been Signed on 10/27/2025 05:16 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:KIDDIE ACADEMY OF HUNTINGTON BEACHFACILITY NUMBER:
304370986
ADMINISTRATOR/
DIRECTOR:		NICOLE CARREONFACILITY TYPE:
830
ADDRESS:19342 BEACH BLVD.TELEPHONE:
(714) 968-0078
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 19DATE:
10/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Loretta MunozTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 10/27/2025, Licensing Program Analysts (LPA) Olivia Meza and Patricia Duron conducted a case management inspection to follow up on a self reported unusual incident that was submitted to CCL Regional Licensing Office on 10/17/2025. LPA Met with the Director, Loretta Munoz. LPAs were taken on a tour of the facility. Census was taken: LPA observed nineteen (19) infants with nine (9) teachers.

According to Loretta Munoz, The Director of the facility, the unusual incident occurred on 10/16/25 that stated while S4 (Staff four) was holding C1 (Child one), and S2 (Staff two) attempted to grab C1 out of S4's arms.

The parents of C1 were made aware that same day that an incident occurred on 10/16/2025. Four out of four staff interviewed stated that they heard or observed the incident on 10/16/2025. S1 (Staff one) stated that S2 (Staff two) placed the children from Infant room two into the infant room one classroom during the incident on 10/16/2025 because S2 stated that they needed to take a break. S1 stated that they talked with the Director about the incident. S2 stated that they were putting their arms out to grab C1 from S2. During the interview, S2 stated that S4 pushed S2 while S4 was holding C1. S3 stated that they reviewed camera footage of the incident and spoke with upper management regarding the incident on 10/16/2025. S3 stated that upper management spoke with S2 and S4 the next day. S4 stated that they were holding C1 in their arms and S2 grabbed C1s leg and yanked it towards S2. S4 stated that they shoved S2 out of the way and left the classroom with C1 in their arms.

(continue to page two)

NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Olivia Meza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2025
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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KIDDIE ACADEMY OF HUNTINGTON BEACH
FACILITY NUMBER: 304370986
VISIT DATE: 10/27/2025
NARRATIVE
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(page two)

The Director stated that both S2 and S4 were given an employee warning notice on 10/24/25 for the incident that occurred on 10/16/2025. As of 10/17/2025 the employee warning notice stated that “Teachers are to be separated.” The Director stated that S2 and S4 were retrained under the guidelines of Title 22 regulations. S2 and S4 reviewed the children personal rights video and preventing workplace violence.

LPAs informed Director, Loretta Munoz that this report dated 10/27/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Refer to 809D for deficiencies cited.

LPAs also informed the Director, Loretta Munoz to provide a copy of this licensing report dated 10/27/25 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.

Violation of CCR Section 101223 Personal Rights (a)(2) was previously cited on 05/29/2025. During today’s visit 10/27/2025, the facility is being cited in the same section of CCR. This is a repeated violation within 12 months, therefore, a civil penalty for repeated violations was issued.

Exit interview conducted and report was reviewed with the Director, Loretta Munoz. A notice of site visit was given and must remain posted for 30 days.

(end of report)

NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Olivia Meza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/27/2025 05:16 PM - It Cannot Be Edited


Created By: Olivia Meza On 10/27/2025 at 04:49 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: KIDDIE ACADEMY OF HUNTINGTON BEACH
FACILITY NUMBER: 304370986

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2025
Section Cited
CCR
101223

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101223 Personal Rights (a)(2)(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The Director stated that they will submit proof to the department that S2 and S4 completed the childrens personal rights video and preventing workplace violence on the date of 10/24/2025.
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This Requirement was not met as evidenced by: Based on interviews, four out of four staff stated that they have heard or observed that while S4 was holding C1, and S2 attempted to grab C1 out of S4's arms. This poses an immediate health, safety or personal rights risk to persons in care.
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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.
Martha Malane
NAME OF LICENSING PROGRAM MANAGER:
Olivia Meza
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2025


LIC809 (FAS) - (06/04)
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