304371532-3-9-2026-06-CC-VTRH-DRZU3S-20260309151402

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371532
Report Date: 03/09/2026
Date Signed: 03/09/2026 03:14:22 PM

Document Has Been Signed on 03/09/2026 03:14 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 ACADEMY		FACILITY NUMBER:	304371532
ADMINISTRATOR/ DIRECTOR:	DE LA TORRE, KATHERN		FACILITY TYPE:	850
ADDRESS:	16498 ROYAL OAK		TELEPHONE:	(949) 559-6810
CITY:	IRVINE	STATE: CA	ZIP CODE:	92618
CAPACITY: 195	TOTAL ENROLLED CHILDREN: 88	CENSUS: 52	DATE:	03/09/2026
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:45 PM
MET WITH:	De La Torre, Kathern (Director)		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 3/9/2026, Licensing Program Analyst (LPA) Vivian Trinh conducted an on-site inspection for the purpose of a Case Management - Legal/Non-compliance. LPA and Director, Kathern De La Torre, toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. The census was taken in individual classrooms. The overall census observed was 52 preschool children with 10 staff members, including the director. The Director stated that total enrollment is currently 88 preschool children. However, children attend different program schedules. During the inspection, it was determined that the facility is operating within its licensed capacity and in compliance with staffing ratios. Facility hours are 7:00 a.m.- 6:00 p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date, 3/9/2026, indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. INDOOR INSPECTION. INDOOR INSPECTION. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. All storage containers for solid waste, including movable bins, have tight-fitting covers that are kept on and are in good repair. The Director stated that there are no firearms and/or other dangerous weapons in the facility; none were observed during the inspection. ON-SITE FOOD PREPARATION: Food prep areas were clean and sanitary. Food is properly stored and labeled. Menus were posted where parents could review them. Floors, equipment, and furniture were clean, in good repair, and free of sharp edges. There is drinking water available to children indoors in water bottles labeled with the child’s name or in a sippy cup. The children's bathrooms are clean and sanitary. Infant changing tables are placed within arm’s reach of a sink. Continued page 2.

NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Vivian Trinh
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

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: 03/09/2026

NARRATIVE

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OUTDOOR INSPECTION: The playground was enclosed by a fence at least 4 feet high. The surface of the outdoor activity space was well maintained and free of hazards. The grass cushioning material, produced for the purpose around the climbing equipment, slides, and other similar equipment, appeared to be sufficient to absorb falls. Drinking water in the outdoor activity space is provided via sippy cups with the child’s name on them. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility ground was safe, sanitary, and in good repair. There were no bodies of water in the facility at the time of inspection. The facility met all posting requirements. The California Child Passenger Safety Law was posted by the entrance of the facility.

PERSONNEL RECORD: Staff files were reviewed for staff present during the facility inspection on 03/09/2026; 5 staff files were reviewed. Health screening and immunization's, as required, were reviewed. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states that a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis and measles for 4 staff members was reviewed and is in compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training and to renew it every 2 years. Mandated Reporter Training was completed, and all staff members are in compliance. At least one staff member present holds current EMSA- approved Pediatric CPR/First Aid certification, which expires 2/16/2026.

CHILDREN’S RECORDS: Children's records were reviewed, and there was a separate, complete and current record for each child. A random sample of five of children's files were reviewed for documentation of the child’s name, address, and telephone number of the child’s authorized representative and of relatives or others that can assume responsibility for the child if the authorized representative cannot be reached when necessary, Immunization records, Consent for Emergency Medical Treatment, Notification of Parent’s Rights (LIC995A), medical assessment and found to be in compliance. In the areas reviewed the children’s files were found to be in full compliance. The sign-in/Sign-out procedure was reviewed and meets regulatory requirements. This facility utilizes an electronic sign-in/out system. Each authorized representative utilizes their own codes as a digital signature.

The Director, Kathern De La Torre, understands that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption prior to the initial presence in a licensed child care 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. Continued page 3.

NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Vivian Trinh
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: EVERBROOK ACADEMY	FACILITY NUMBER: 304371532
	VISIT DATE: 03/09/2026

NARRATIVE

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The LPA discussed the following resources with Director, Kathern De La Torre and reminded her that it is her responsibility to review the information in more detail.

During the visit, the Director, Kathern De La Torre was reminded that Licensing Quarterly Updates are available at https://www.cdss.ca.gov/inforesources/community-care/self-assessment-guides-and-key-indicator-tools/quarterly-updates. The director understands it is her responsibility to review the Provider Information Notices (PIN) found on the CCLD website above.

The Director, Kathern De La Torre understands that she may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe.
The LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian and at CaSocialService YouTube Guardian Webinar “All Providers Webinar 12/20/22” link https://youtu.be/WNc1kYmlW9s.
The director was informed of the resources available to providers at https://ccld.childcarevideos.org/family-child-care-providers/.
The director was informed that Title 22 regulations may be accessed at https://www.cdss.ca.gov/inforesources/letters-regulations/legislation-and-regulations/community-care-licensing-regulations/child-care

In the areas that were evaluated, no deficiencies were observed in the California Code of Regulations, Title 22, Division 12 at the time of the visit.

Exit interview conducted, and the report was reviewed with Director Kathern De La Torre. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The Director Kathern De La Torre was provided a copy of their appeal rights (LIC 9058), and their signature on this form acknowledges receipt of these rights.

End of the Report.

NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Vivian Trinh
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

LIC809 (FAS) - (06/04)

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