<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605901
Report Date: 08/24/2026
Date Signed: 08/24/2026 03:49:49 PM

Document Has Been Signed on 08/24/2026 03:49 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:OUR SAVIOUR'S LUTHERAN CHILDREN'S CENTERFACILITY NUMBER:
300605901
ADMINISTRATOR/
DIRECTOR:
GATES, JENNIFERFACILITY TYPE:
830
ADDRESS:800 N CAMBRIDGETELEPHONE:
(714) 771-5040
CITY:ORANGESTATE: CAZIP CODE:
92867
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 8DATE:
08/24/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:58 PM
MET WITH:Director-Jennifer GatesTIME VISIT/
INSPECTION COMPLETED:
04:00 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
On 08/24/2026, Licensing Program Analyst (LPA) Navar conducted an unannounced Annual Random Inspection at the facility. LPA met with Director Jennifer Gates and conducted a facility tour of the indoor and outdoor areas of the center. A census was taken in individual classrooms, with a total of 7 infants supervised by 4 infant staff. Staffing was found to be within licensed capacity and in compliance with Title 22 regulations. LPA observed staff engaged in appropriate supervision and providing support to infants’ needs.

A review of the Facility Personnel Report Summary confirmed that all staff and individuals subject to caregiver background checks had obtained criminal record clearances or exemptions. All required postings were present, including the California Child Passenger Safety Law notification.

Facility operating hours are 7:00 a.m.- 6:00 p.m., Monday through Friday. Sign in/out procedure was reviewed for compliance. Facility uses an app called Bright Wheel. The person who signs the child in and out scans the QR code and then enters a pin number that is linked to their full legal signature and records the time of the day.


Continue to page 2.
Thuy Ho
Karen Navar
DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2026
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 6
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)
Page: 2 of 6
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: OUR SAVIOUR'S LUTHERAN CHILDREN'S CENTER
FACILITY NUMBER: 300605901
VISIT DATE: 08/24/2026
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
26
27
28
29
30
31
32
Page 3

5 staff files were reviewed for compliance. There was a complete and separate file for all staff containing health screenings and required immunizations that were verified and found to be in compliance, as required by Health and Safety Code section 1597.622, immunization records for pertussis and measles.

Mandated Reporter Training, required under Health and Safety Code section 1596.8662, was current for all 5 staff. At least one staff member present held a current EMSA-approved Pediatric CPR/First Aid certification, expiring 9/2026.

5 children’s files were reviewed and found complete and current. LPA reviewed LIC 9227 Individual Infant Sleeping Plans, Needs and Service plans, and verified documentation of 15-minute sleep checks. Infant records were in full compliance.

LPA discussed safe sleep regulations and provided the Child Care Licensing Safe Sleep webpage as an additional resource. LPA also advised the Director to regularly check the U.S. Consumer Product Safety Commission (CPSC) website for recalled infant equipment and recommended registering all infant devices to ensure notification of any product recalls.

Lead testing was completed on 12/21/2023, with no exceedances observed. 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. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

Continue to page 4.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Karen Navar
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: OUR SAVIOUR'S LUTHERAN CHILDREN'S CENTER
FACILITY NUMBER: 300605901
VISIT DATE: 08/24/2026
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
26
27
28
29
30
31
32
Page 2

The indoor activity space was inspected. Detergents, cleaning compounds, medications, and other hazardous items were stored inaccessible to children. No poisons were kept on site. The facility prepares food on site; food is brought from home. Food preparation areas were clean and sanitary, and all bottles, food items, and infant supplies were individually labeled and properly stored.

Floors, furnishings, and equipment were clean, in good repair, and free of hazards. Drinking water was available indoors through Britta PItchers, staff refill children’s cups as needed throughout the day. The diaper-changing area was maintained in a sanitary condition, with sink within arm’s reach. Infants napped in cribs or on cots, and bedding was stored individually and laundered by parents.

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. There is rubber cushioning material and artificial grass commercially produced for the purpose of surrounding the mini moveable climbing equipment and mini slides. Age-appropriate equipment and dramatic play materials were observed in good repair and free of sharp edges. Drinking water in the outdoor activity space is provided by Britta Pitchers and children bring sports bottles with the child’s name on it to refill if needed. The facility grounds were safe, sanitary and in good repair. No bodies of water were observed on the premises.

The facility conducted an emergency drill within the past six months; the most recent documented drill was a fire drill conducted on 07/21/2026. A functional carbon monoxide detector and an operational fire extinguisher were observed.

Continue to page 3.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Karen Navar
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: OUR SAVIOUR'S LUTHERAN CHILDREN'S CENTER
FACILITY NUMBER: 300605901
VISIT DATE: 08/24/2026
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
26
27
28
29
30
31
32
Page 4
This facility provides Incidental Medical Services – IMS. LPA and director discussed medication and director stated there are no children enrolled at this time who take medication. 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 Director was also informed of the MyChildCarePlan.org website, a consumer education resource connecting families to childcare providers and Resource and Referral agencies.

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

LPA reminded the facility representative that all adults age 18 and older who are responsible for administration or supervision of staff, who provide care and supervision to children, or who have contact with children must obtain a criminal record clearance or exemption prior to initial presence in the childcare center. Failure to comply may result in civil penalties of $100 per day, per person, for up to five days or up to thirty days for repeat violations.

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov the director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov

Continue to page 5.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Karen Navar
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: OUR SAVIOUR'S LUTHERAN CHILDREN'S CENTER
FACILITY NUMBER: 300605901
VISIT DATE: 08/24/2026
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
26
27
28
29
30
31
32
Page 5

No deficiencies were observed during today’s inspection in accordance with the California Code of Regulations, Title 22, Division 12.

An exit interview was conducted with Director Jennifer Gates. A Notice of Site Visit was issued and must remain posted for 30 consecutive days.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Karen Navar
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026
LIC809 (FAS) - (06/04)
Page: 6 of 6