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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371547
Report Date: 04/30/2026
Date Signed: 04/30/2026 01:41:36 PM

Document Has Been Signed on 04/30/2026 01:41 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:ORANGE TREE CHRISTIAN PRESCHOOLFACILITY NUMBER:
304371547
ADMINISTRATOR/
DIRECTOR:		DAVIS, SAVANNAHFACILITY TYPE:
850
ADDRESS:2115 NEWPORT BLVD.TELEPHONE:
(949) 458-1382
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY: 60TOTAL ENROLLED CHILDREN: 43CENSUS: 26DATE:
04/30/2026
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:03 AM
MET WITH:Facility Representative, Savannah DavisTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 04/30/2026, Licensing Program Analyst (LPA) Deschampe conducted a quarterly unannounced Case Management - Legal/Non-Compliance inspection for the purpose of ensuring the facility is in compliance with California Title 22 Regulations, Health and Safety Codes, and the Stipulation Modifying Proposed Decision; And Order, dated 12/22/2025. LPA arrived at the facility at 9:03 AM and was allowed entry by the Facility Representative/Director (FR), Savannah Davis. LPA informed the FR the purpose of the visit. FR guided LPA on a tour of the center which has a total enrollment of 43, and a current census of 26 children and 4 staff, due to various student schedules. During the inspection it was determined the facility is operating within compliance of staff to child ratios. Facility hours are Monday - Friday 7:30 AM - 6:00 PM.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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. Dry snacks are provided for children, while meals are brought from home. All food is selected, stored, and served in a safe and healthful manner. Personal water bottles are properly labeled. Drinking water is provided by Brita water pitchers refilled by faucets in Rooms 101 and 102. Menus are posted where they can be reviewed by parents/authorized representatives.
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2026
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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 04/30/2026
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Floors, equipment, and furniture were clean and observed to be in good repair and free of sharp edges. The children's bathrooms are clean and sanitary. Children nap on mats, bedding is stored individually and is taken home daily to be washed by parents/authorized representatives. The center has conducted an emergency drill within the past six months and keeps documentation of drills (12/05/2025). The center has a at least one working smoke detector, one working carbon monoxide detector and at least one functioning fire extinguisher. The facility was cleared by the City of Costa Mesa Fire & Rescue Department Community Risk Reduction Division on 02/03/2026. Facility meets all posting requirements. California Code of Regulations (CCR) Section 101161 Limitations on Capacity (a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met through the use of an unlicensed classroom 104. LPA observed 10 preschool children participate in a 30 minute gymnastics class with a Third Party Vendor, Webby Dance with 1 facility staff present in the room (adjacent to the classrooms and staff bathrooms). LPA confirmed through interview, classroom 104 is used every Thursday for 30 minutes with the preschool children enrolled at the facility. This poses a potential health and safety hazard for preschool children in care.

The outdoor activity space was inspected for compliance. Required shade, drinking water and fencing were inspected. The playground is enclosed by a fence at least four feet in height and is in good repair. The surface of the outdoor activity space is maintained and free of hazards. The cushioning material around outdoor play equipment and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by water bottles. The outdoor equipment and toys are in good repair and free of sharp edges. There are no bodies of water present at the facility. LPA observed the baptismal pool was drained with a black net covering. The outdoor activity space was in compliance.

Staff files were reviewed for staff present during the facility inspection on this date. Proof of immunization against pertussis, measles for staff members were reviewed and within compliance. Beginning March 31, 2018, Health and Safety Code 1596.8662 requires all directors and employees to complete mandated reporter training, and to renew the training every two years. All reviewed staff files have current Mandated Reporter Training certificates. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications. 4 out of 4 staff files were in compliance.
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547
VISIT DATE: 04/30/2026
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Children's records were reviewed, and there was a separate, complete and current record for each child. In the areas reviewed, 7 out of 7 children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The authorized representative who signs the child in and out uses their unique log in via ProCare application and records the time of the day.

In the areas that were evaluated, the following deficiency was observed of the California Code of Regulations, Title 22, Health and Safety Codes, or Stipulation Modifying Proposed Decision; And Order, at the time of the visit.

California Code of Regulations (CCR) Section 101161(a) Limitations on Capacity

The exit interview was conducted with the facility representative, Savannah Davis. The Notice of Site Visit was posted during the visit. A notice of site visit was given and must remain posted for 30 consecutive days. The “Notice of Site Visit” must be posted on, or immediately adjacent to, the interior side of the main door to the facility. Failure to post will result in Civil Penalties of $100.00. Appeal Rights were discussed and provided to the facility representative and their signature on this form acknowledges receipt of these rights. Facility representative must file an appeal, in writing, to the Regional Manager within 15 business days from the date of receiving the penalty assessment or notice of deficiency. First level appeals should be sent to the Regional Manager at the address listed above.

End of Report.
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 04/30/2026 01:41 PM - It Cannot Be Edited


Created By: Susan Deschampe On 04/30/2026 at 11:03 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: ORANGE TREE CHRISTIAN PRESCHOOL
FACILITY NUMBER: 304371547

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/04/2026
Section Cited
CCR
101161(a)

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Limitations on Capacity: A licensee shall not operate a child care center beyond the conditions & limitations specified on the license,... This requirement is not met as evidenced by: LPA observation & interview, a Third Party Provider conducted a 30 min. gymnastics class w/10 preschool children
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Facility to submit waiver request to LPA.
Facility will not use Room 104 until waiver has been approved.
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w/1 facility staff present. Per interview, this class is every Thurs. for 30 minutes in this room (not w/in licensing conditions). Per record review, license states, "Rooms 101, 102, and 103. This poses/posed a potential 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.
Thuy Ho
NAME OF LICENSING PROGRAM MANAGER:
Susan Deschampe
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2026


LIC809 (FAS) - (06/04)
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