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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371532
Report Date: 06/09/2025
Date Signed: 06/09/2025 06:59:25 PM

Document Has Been Signed on 06/09/2025 06:59 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:EVERBROOK ACADEMYFACILITY NUMBER:
304371532
ADMINISTRATOR/
DIRECTOR:		DE LA TORRE, KATHERNFACILITY TYPE:
850
ADDRESS:16498 ROYAL OAKTELEPHONE:
(949) 559-6810
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 195TOTAL ENROLLED CHILDREN: 195CENSUS: 46DATE:
06/09/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:De La Torre, Kathern (Director)TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On June 9, 2025, at 9:00 am, Licensing Program Analysts (LPAs), Vivian Trinh and (LPA) Kathy Trinh conducted an unannounced Case Management for the purpose of inspecting the outdoor activity space. Upon arrival, LPAs met with Director De La Torre, Kathern. The overall census observed was 9 preschool staff members including the director and 46 preschool children. Facility hours are 6:30 AM TO 6:30 PM, Monday through Friday. Appropriate ratios and supervision were observed. All outdoor activity space utilized for the children were inspected today. LPAs informed director De La Torre, Kathern, that staff members are required to always maintain direct visual supervision of the children during indoor and outdoor activities.

CRIMINAL RECORD CLEARANCE: A review of the Facility Personnel Report Summary on this date 6/9/2025. The Director De La Torre, Kathern understands that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to the initial presence in a licensed childcare facility. Violation of this requirement will result in a citation of a deficiency and civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days. Subsequent violations within a twelve (12) month period will result in a civil penalty of one hundred dollars ($100) per violation per day for a maximum of thirty (30) days in accordance with Section 1596.871 of the Health and Safety Code.

LPAs continued to tour the facility and measured the newly fenced outdoor activity space, which is sufficient to accommodate the current capacity of 195.

Continued Page 2.

NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Vivian Trinh
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2025
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: EVERBROOK ACADEMY
FACILITY NUMBER: 304371532
VISIT DATE: 06/09/2025
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The LPAs inspected the outdoor areas. The playground was enclosed by a brick fence at least four feet in height and is in good repair. At the time of inspection, the surface of the outdoor activity area was maintained and free of any observable hazards. There is a climbing structure on the playground for children in preschool yard 3. The areas around and under high climbing equipment and other similar equipment were cushioned with artificial grass commercially produced for the purpose of material that absorbs falls. While waiting for the additional playground structure to be installed, Director provided to LPAs with the rotation schedule for each preschool classrooms when using the playground structure in preschool yard 3. During the Inspection, Director stated that preschool yard 1 and preschool yard 2 will install new playground structures with the manufacture’s sticker with identifying the age it is intended. LPAs reminded the Director that an inspection by licensing must be conducted before children can use the new playground structures. Shade is provided by an Easy Up, and a square shade structure in each of the preschool yard. The outdoor equipment and toys are in good repair and free of sharp edges. There is drinking water available to children outdoors in sports bottles with children’s names or water pitchers with plastic cups. There are no bodies of water present at the facility. Director De La Torre, Kathern, was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

No corrections are needed. LPA observed outdoor activities are safe.


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

Appeal Rights were discussed. The facility representative was provided a copy of their 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.

End of the Report.

NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Vivian Trinh
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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