304270168-9-23-2025-06-CC-PDUN-DLSQWP-20250923123217

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270168
Report Date: 09/23/2025
Date Signed: 09/23/2025 12:32:39 PM

Document Has Been Signed on 09/23/2025 12:32 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:	LOS ALAMITOS CHILD DEVELOPMENT CENTER-WEAVER SITE		FACILITY NUMBER:	304270168
ADMINISTRATOR/ DIRECTOR:	CAROLYN WERTHEIM		FACILITY TYPE:	850
ADDRESS:	11872 WEMBLEY ROAD		TELEPHONE:	(562) 799-4585
CITY:	LOS ALAMITOS	STATE: CA	ZIP CODE:	90720
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 48	CENSUS: 33	DATE:	09/23/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:45 AM
MET WITH:	Facility Coordinator, Nadia Williams.		TIME VISIT/ INSPECTION COMPLETED:	01:00 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	Page 1 of 3 On September 23, 2025, Licensing Program Analysts (LPAs), Thompson and Duron conducted an inspection of this facility for the purpose of adding classrooms 1 & 2 and removing classrooms 3 & 5 to the facility license. LPAs met with the Facility Coordinator, Nadia Williams. LPAs took census. There were 33 preschool children with five staff. The facility is currently licensed to serve 48 Children Ages 2.9 - 5 years of age. Monday - Friday, 7:00 am - 6:00 pm in classroom #3 and classroom #4. Classrooms 1 & 2 are located in building C located at the same address as classrooms 3 & 5. Facility Coordinator was informed, a new application will need to be submitted, a new fire clearance will need to be granted, and an inspection will need to be completed prior to moving into a new building or changing classrooms in the future. The facility has requested to provide care and supervision in classrooms 1 & 2. The facility is currently licensed to serve 48 Children Ages 2.9 - 5 years of age. The capacity and age range for children will not be changed. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Continued on page 2

NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Patricia Duron
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

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: LOS ALAMITOS CHILD DEVELOPMENT CENTER-WEAVER SITE	FACILITY NUMBER: 304270168
	VISIT DATE: 09/23/2025

NARRATIVE

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All indoor and outdoor activity space utilized for the children was inspected today. There is an operational carbon monoxide detector on site. All required licensing documents were observed posted inside the classrooms. Parents sign in and sign out on paper.

LPAs measured two classrooms (classrooms #1 and classroom #2 located in building C). Total indoor activity space measured at 2317.32 Square feet, which is sufficient to accommodate the overall capacity of 48 preschool children. LPAs observed age-appropriate furniture and equipment, including tables, chairs, cubbies, and mats.

LPAs observed all hazardous items to be inaccessible to children. LPAs observed a total of four sinks and four toilets. Two sinks, two toilets inside classroom #1 and two sinks, two toilets inside classroom #2 available for children’s use. The total number of sinks and toilets are sufficient to accommodate a capacity of 48 children. There is a separate restroom equipped with a toilet and a sink for staff inside the elementary school office.

The isolation area for children who are ill will be in the nurses office located inside the main elementary school office.

Facility provides morning snack, afternoon snack, and lunch to children. Menu is posted and available for parents to view.

The outdoor space for preschool children was inspected. The outdoor space for preschool children measured at 5397.63 square feet and can accommodate the capacity of 48 preschool children. The outdoor spaced is fully fenced. The surface on the playground is concrete and grass. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. The facility also has a waiver for a separate outdoor space and bathrooms on file.

Continued on page 3

NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Patricia Duron
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

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: LOS ALAMITOS CHILD DEVELOPMENT CENTER-WEAVER SITE	FACILITY NUMBER: 304270168
	VISIT DATE: 09/23/2025

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP on 04/17/2023. There is no lead exceedance on the facility lead report.

LPAs provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian.

Facility coordinator was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301(voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at:https://www.ada.gov/resources/child-carecenters

The facility coordinator, was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Patricia Duron
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: LOS ALAMITOS CHILD DEVELOPMENT CENTER-WEAVER SITE	FACILITY NUMBER: 304270168
	VISIT DATE: 09/23/2025

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at:https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communications.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at this inspection date.

Fire clearance has been granted for the requested classroom change and capacity of 48 preschool children on August 26, 2025.

Based on today's measurement of indoor/outdoor, and number of sinks and toilets, the facility meets the requirements for the capacity of 48 preschool children in classrooms #1 and #2. The facility will be granted the classroom change after final review and approval of the management.

A notice of site visit was given to Nadia Williams and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview was conducted with facility coordinator, Nadia Williams.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Patricia Duron
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

LIC809 (FAS) - (06/04)

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