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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370423
Report Date: 01/29/2024
Date Signed: 01/29/2024 09:32:12 AM


Document Has Been Signed on 01/29/2024 09:32 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:ST. MARK COMMUNITY PRESCHOOLFACILITY NUMBER:
304370423
ADMINISTRATOR:CARRILLO, NOEMIFACILITY TYPE:
850
ADDRESS:2200 SAN JOAQUIN HILLS ROADTELEPHONE:
(949) 644-1442
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92660
CAPACITY:72CENSUS: 5DATE:
01/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Director Maggie BrewerTIME COMPLETED:
09:45 AM
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On 1/29/2024 Licensing Program Analyst (LPA) A. Silva conducted an unannounced incident investigation inspection. This is a continuation of the investigation initiated on 12/6/2023. Upon arrival, the LPA met with Director Maggie Brewer and informed the director of the purpose of the visit. A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance. The director led the LPA on a tour of the facility. The census at the time of the visit was 5 children and two staff.

The Department received an incident report on 11/30/2023 stating that Child #1 (C1) came out of a classroom when Adult #1 (A1) opened the door. The report indicates that “it is unclear when/how C1 got into the classroom.” The child did not sustain any injuries.

Interviews with staff: On 12/6/2023 the LPA interviewed six staff at the facility. All staff consistently stated that they did not see C1 go inside the classroom. Staff 1 explained that C1 suddenly appeared behind the door when Adult #1 opened the door. Staff stated the child disappeared for about 30 second to a minute.

Interview with Parents: On 1/17/2024, the LPA called 10 parents for an interview. Six parents were interviewed. The other four did not respond to the department's request for an interview. The parents interviewed did not express any concerns about the care and supervision at the preschool.

Interviews with adults: On 1/17/2024, the LPA interviewed Adult #1 (A1) over the phone. A1 stated, “I opened the door, the child came out of the classroom” and added “It seemed like the kid was holding on to the door to come out but was not strong enough to come out. The teachers were next to me, and they were like oh my god!” A1 was asked whether the teachers were inside the classroom. A1 responded, “outside.”

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SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo SilvaTELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ST. MARK COMMUNITY PRESCHOOL
FACILITY NUMBER: 304370423
VISIT DATE: 01/29/2024
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Based on interview statements and records review, a violation of the California Code of Regulations, Title 22, Division 12 was observed, discussed, and cited at the time of the visit. The following type A violation of the California Code of Regulations, Title 22; Division 12, was cited: 101229(a)(1) Responsibility for Providing Care and Supervision.

LPA A. Silva informed Director Maggie Brewer that this licensing report dated 1/29/2024 documents one “Type A” citation. Type A citation(s) must be posted for 30 consecutive days during the hours that children are in care as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. LPA A. Silva further informed the director that a copy of this licensing report must be provided to parents or guardians of all clients currently enrolled by the next business day or by the next day the children are in care, a copy of this report must be provided to the parents or guardians of all newly enrolled clients for 12 months from the date of this report, and signed Acknowledgement of Receipt of Licensing Report (LIC 9224) form, or another written equivalent statement, must be placed in the child's file for verification of receipt of the report.

An exit interview was conducted with Director Maggie Brewer. The Notice of Site Visit was posted during the visit. The director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First-level appeals should be sent to the regional manager to the address listed above.

END.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo SilvaTELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/29/2024 09:32 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: ST. MARK COMMUNITY PRESCHOOL
FACILITY NUMBER: 304370423

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time, ... Supervision shall include visual observation. The licensee did not meet with the regulation above as evidenced by:
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The Director stated she will re-write the supervision schedule to reflect that watching the doors is part of each teacher's supervision station. The director will provide a copy of the schedule to the LPA by 1/29/2024.
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Based on interviews and records review, the licensee did not meet the above regulation in 1 out of 28 children in care who were left unsupervised. Child #1 was left without supervision inside a classroom for about 30-60 seconds.
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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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Archibaldo SilvaTELEPHONE: (510) 504-4954
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024
LIC809 (FAS) - (06/04)
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