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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370933
Report Date: 06/09/2025
Date Signed: 06/09/2025 09:31:58 AM

Document Has Been Signed on 06/09/2025 09:31 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:RAINBOW KIDS ACADEMYFACILITY NUMBER:
304370933
ADMINISTRATOR/
DIRECTOR:		CYRANO ANTONYFACILITY TYPE:
850
ADDRESS:12914 HAZEL AVENUETELEPHONE:
(714) 638-8210
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: 15DATE:
06/09/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Facility Representative, Nancy DizonTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Dianna Valdez Santana conducted an on-site inspection for the purpose of a Case Management Incident Inspection on 06/9/2025. LPA toured the facility. Census was taken in individual classrooms, there were 3 children in the toddler class with 1 staff, there 7 preschool age-children in the preschool class being cared for by 1 staff, and 5 preschool children in the pre-k class being cared for by 1 staff. There was a total of 15 preschool-age children present at the time of inspection. Today's Case Management inspection is being conducted in response to a self-reported incident, reported to the OC CCL office on 02/28/25, detailing child #1 (C1) and child #2 (C2) authorized representatives informed the facility that C1 told them that C1’s teacher pulled C1 by the shirt. Additionally, C2 told them that someone had “pow powed” (hit) C1 on the hand. It was reported that the facility staff may have violated C1 and C2’s personal rights.

A review of the Facility Personnel Report Summary conducted on today’s date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the inspection, LPA interviewed 5 staff and child #1 (C1) involved in the incident. C1 did not make disclosures during the interview. LPA was unable to interview Child #2 (C2) due to age and limited speech. Staff 1 (S1) denied pulling C1 from the shirt and does not know why C1 would say that. Staff #2 (S2) and Staff #3 (S3) both denied seeing S1 pull C1 from the shirt. S2 disclosed telling C2 not to “pow pow” the other children and will hit S2’s own hand and not ever C2’s. S2 thinks C2 may have gotten confused. Page 1 of 2
NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Dianna ValdezSantana
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2025
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: RAINBOW KIDS ACADEMY
FACILITY NUMBER: 304370933
VISIT DATE: 06/09/2025
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However, Staff 4 (S4) stated C1 disclosed to S4 and Staff #6 (S6) that S1 pulled C1 from the shirt. LPA interviewed C1 and C2’s parents, Parent #1 (P1) stated, P1 and Parent #2 (P2) picked up C1 and C2 from the facility and P2 asked how their day went. C2 said that someone had "pow powed" C2 but did not say any staff names. P1 is not even sure C2 knows their names. Then C1 told P1 and P2 that S1 pulled C1 from C1’s shirt, C1 showed P1 and P2 that it was from C1’s back collar. During LPA's interview C1 denied S1 hurt C1.

Based on observations and interviews conducted with staff and C1, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.



No deficiencies were cited under the California Code of Regulations Title 22 Division 12 during today's visit.

Exit interview was conducted with facility representative. The Notice of Site Visit was posted for no less than 30 consecutive days. Appeal Rights were explained. A copy of appeal rights (LIC 9058 1/16) was provided and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

Page 2 of 2. End of Report
NAME OF LICENSING PROGRAM MANAGER: Martha Malane
NAME OF LICENSING PROGRAM ANALYST: Dianna ValdezSantana
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2025
LIC809 (FAS) - (06/04)
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