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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371024
Report Date: 05/31/2022
Date Signed: 05/31/2022 02:31:09 PM

Document Has Been Signed on 05/31/2022 02:31 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:OC KIDS INFANT & PRESCHOOLFACILITY NUMBER:
304371024
ADMINISTRATOR:DUNG (MEGAN) PHANFACILITY TYPE:
850
ADDRESS:11362 BROOKHURST STREETTELEPHONE:
(714) 530-7263
CITY:GARDEN GROVESTATE: CAZIP CODE:
92840
CAPACITY: 82TOTAL ENROLLED CHILDREN: 82CENSUS: 83DATE:
05/31/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:46 PM
MET WITH:Office assistant Candace Galvan (Hoodye)TIME COMPLETED:
02:40 PM
NARRATIVE
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Licensing program analyst (LPA) Tina Nguyen conducted a case management visit due to deficiency observed during complaint investigation visit on 05/31/2022. On 05/31/2022, LPA Nguyen arrived at the facility at 11:20 AM. LPA Nguyen met with office assistant Candace Galvan and toured the facility. During the inspection, LPA Nguyen observed 8 staff members are providing care for 83 children. Staff #1 is providing care for 12 children (3 years old group); staff #2 is providing care for 12 children (2-3 years old group); staff #3 and staff #4 are providing care for 14 children ( 2 years old group); staff #5 is providing care for 12 children (4 years old group); staff #6 is providing care for 12 children ( 5 years old group); staff #7 is providing care for 12 children ( 4-5 years old group); and staff #8 is providing care for 9 children ( 4 years old group). The facility is licensed to care for 82 children age 2- 6 years of age.

Based on LPA observations, interview and record reviews, the facility was operating over capacity. The facility representative was advised of over capacity violation and a correction needs to be made by today. Capacity compliance has to be maintained at all times for the safety of the children in care. During today's inspection, the facility was cited type A violation under the California Code of Regulations, Title 22, Division 12, Chapter 1, Article 02. Licensing 101161 (a) Limitations on Capacity. Please refer to the attached 809D for documentation of deficiency

The facility received a Type A violation, the facility shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the facility shall immediately post upon receipt the Proof of Correction for 30 consecutive days, and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. Continue on page 2
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: OC KIDS INFANT & PRESCHOOL
FACILITY NUMBER: 304371024
VISIT DATE: 05/31/2022
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Exit interview was conducted with office assistant. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. Licensee was informed of how/where to access regulations and forms from CCLD website: www.cdss.ca.gov. The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Tina Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/31/2022 02:31 PM - It Cannot Be Edited


Created By: Tina Nguyen On 05/31/2022 at 01:01 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: OC KIDS INFANT & PRESCHOOL
FACILITY NUMBER: 304371024

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/31/2022
Section Cited
CCR
101161(a)

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101161 Limitations on Capacity
(a) A licensee shall not operate a childcare center beyond the conditions and limitations specified on the license, including the capacity limitation.

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Facility representive indicated that the facility will make sure Capacity compliance has to be maintained at all times for the safety of the children in care. Facility representative will send LPA Nguyen the plan to prevent the over capacity occurring again.
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Based on the observation, interview and record review, at 11:20 AM, LPA Nguyen observed 83 preschool children. The facility is licensed to care for 82 children 2-6 years of age. This poses an immediate Health and Safety risk to the children 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.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Tina Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022


LIC809 (FAS) - (06/04)
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