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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371441
Report Date: 02/28/2025
Date Signed: 02/28/2025 11:25:07 AM

Document Has Been Signed on 02/28/2025 11:25 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:ACACIA MONTESSORI SCHOOLFACILITY NUMBER:
304371441
ADMINISTRATOR/
DIRECTOR:		CHUNG, SUNFACILITY TYPE:
850
ADDRESS:1701 EAST CHAPMAN AVENUETELEPHONE:
(714) 526-7855
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 18DATE:
02/28/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Director Sun ChungTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
NARRATIVE
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On 02/28/25, a case management inspection was conducted by Licensing Program Analyst (LPA) Anna Chan. LPA met with Director Sun Chung. Upon arrival there were 2 staff present and 18 preschool children in care.

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

During a complaint investigation, it was discovered that Staff 1 (S1) is not a fully qualified teacher who was at room #2 alone with the children. S1 only has 6 units of Child Development (Child Growth Development and Child, Family-Community).

In the areas evaluated, it was determined that the facility violated California Code of Regulations, Title 22, Division 12, Section 101216.1(c)(1)(A) Teacher Qualifications and Duties. See Type B deficiency cited on LIC809D



Exit interview was conducted with Director, Sun Chung. The Notice of Site Visit was posted.

Appeal Rights and deficiency was explained. A copy of appeal rights (LIC 9058 1/16) was provided and their signatures on this form acknowledge receipt of these rights. The first level appeal is to Regional Manager, address is above on the report.

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
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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Document Has Been Signed on 02/28/2025 11:25 AM - It Cannot Be Edited


Created By: Anna Francesca Chan On 02/28/2025 at 10:40 AM
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371441

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/07/2025
Section Cited
CCR
101216.1(c)(1)(A)

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101216.1(c)(1)(A)
(c) To be a fully qualified teacher, a teacher shall have one of the following:
(1) Twelve post-secondary semester...(A) ...general areas of child growth and development, or human growth and development; child, family and community,
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Director stated sttaff was a sub from agency. Director stated the facility will make sure there is a fully qualified teacher per classroom and will make sure to review staff file before starting. Facility will send LPA a documentation that this incident will not happen again.
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 or child and family; and program/curriculum. This requirement was not met as evidenced by: Based on observation and record review, staff 1 (S1) was not a fully qualified and was alone in the classroom with 6 children. This poses a potential risk to health and safety of the children in care
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During the visit the facility placed a fully qualified teacher with the sub (Aide) in classroom #2.

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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:Martha Malane
LICENSING EVALUATOR NAME:Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


LIC809 (FAS) - (06/04)
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