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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370987
Report Date: 10/09/2023
Date Signed: 10/09/2023 11:20:05 AM


Document Has Been Signed on 10/09/2023 11:20 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:KIDDIE ACADEMY OF HUNTINGTON BEACHFACILITY NUMBER:
304370987
ADMINISTRATOR:CARREON, NICOLEFACILITY TYPE:
850
ADDRESS:19342 BEACH BLVDTELEPHONE:
(714) 968-0078
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:124CENSUS: 59DATE:
10/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Nicole CarreonTIME COMPLETED:
12:00 PM
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The purpose of this inspection was to conduct a second unannounced visit due to a self-reported incident report received on 10/03/2023. Licensing Program Analyst (LPA) Romy Castanon met with Director Nicole Carreon. LPA toured 5 preschool rooms (Room #5, #6, #8, #9 and #10). Observed at the time of the visit was a total of 59 children with 9 staff.

A review of the Facility Personnel Report Summary on 10/09/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During today’s inspection, LPA Castanon interviewed 3 staff members and 4 children.


Due to insufficient information available at this time further investigation is needed.

Exit interview was conducted with Director Nicole Carreon. The Notice of Site Visit was posted. Director was advised the Notice of Site Visit must be posted for 30 days. (End of Report)
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Romelia M CastanonTELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2023
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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