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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370847
Report Date: 09/10/2024
Date Signed: 09/10/2024 01:59:37 PM


Document Has Been Signed on 09/10/2024 01:59 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:NOBIS PRESCHOOLFACILITY NUMBER:
304370847
ADMINISTRATOR:BENAVIDES, ERICAFACILITY TYPE:
830
ADDRESS:26153 VICTORIA BLVD.TELEPHONE:
(949) 661-6258
CITY:CAPISTRANO BEACHSTATE: CAZIP CODE:
92624
CAPACITY:16CENSUS: 10DATE:
09/10/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Staff in charge, Gail ReyesTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the above program while inspecting the preschool program. LPA met with staff in charge, Gail Reyes who was supervising 8 preschool children on the playground. Melinda Marchese from the sister facility in Costa Mesa arrived during LPA's inspection. LPA observed 10 infants and toddlers with 3 staff in the infant room.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Based on the interviewed with staff, LPA found out that 3 toddlers belong to Toddler Option Program are commingled with the infant toddler program. Staff stated the facility has combined the children belong to Toddler Option Program with Infant Program due to some staff rsignations. LPA reviewed the children's files and found out Child # 2, 3, and 4 are courently enrolled in Toddler Option Program. LPA obsereved that those children were among the infant toddler program. Staff stated there is one staff for Mondays, Wednesdays, Fridays for Toddler Option Program and they are in the process of hiring another staff for other days to cover the Toddler Option Program.

Type B under California Title 22 Regulations Sections under are cited on 9099D next page. The facility representative, Melinda Melinda Marchese, was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00. The facility representative, Melinda Melinda Marchese, was provided with 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. The exit interview was conducted with The facility representative, Melinda Melinda Marchese,
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 09/10/2024 01:59 PM - 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: NOBIS PRESCHOOL
FACILITY NUMBER: 304370847

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
HSC
1596.956(6)

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Child day care centers serving infants; optional toddler program; The toddler program shall be conducted in areas separate from those used by older or younger children. Plans to alternate use of outdoor play space may be approved to achieve separation. This requirement
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The facility representative stated she would send a correction plan for this violation. They are in the process of hiring a new staff to keep the toddler option children separately.
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 was not met as evidenced by LPA's observation and reviewing documents C2, C3, and C4 belonged to Toddler Option Program and were commingled with infants and toddlers. This is a potential risk to the health and safety of children in care.
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The correction plan will be sent to LPA's email address by the due date of 9/17/2024.

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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: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2024
LIC809 (FAS) - (06/04)
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