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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370149
Report Date: 01/08/2026
Date Signed: 01/08/2026 03:04:55 PM

Document Has Been Signed on 01/08/2026 03:04 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:NOBIS PRESCHOOLFACILITY NUMBER:
304370149
ADMINISTRATOR/
DIRECTOR:		MELINDA MARCHESEFACILITY TYPE:
850
ADDRESS:190 EAST 15TH STREETTELEPHONE:
(949) 548-2550
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 19DATE:
01/08/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Facility Representative, Melinda MarcheseTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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In conjunction with an inspection on 01/08/2026, Licensing Program Analyst (LPA) Deschampe arrived at the facility at 10:15 AM and was allowed entry to the facility by Assistant Director, Nirosha Rathnayaka. Nirosha guided LPA on a tour of the facility and LPA obtained the following census: 19 children with 3 staff. Melinda Marchese, Facility Representative/Director arrived at the facility at approximately 11:15 AM.

A review of the Facility Personnel Report Summary conducted on this date, 01/08/2026 indicates 1 out of 4 facility staff or other individuals who require caregiver background checks do not have current criminal record and child abuse index clearances or exemptions.

Health and Safety Code 1596.871(c)(1)(A) Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. During today's inspections, LPA observed from approximately 10:15 - 11:30 AM, Staff 1 (S1) providing care to children enrolled including, providing snacks, playground observation, and guided play activities. Based on interviews with S1 and Melinda, S1 has been working at the facility since 10/2025. Per record review, S1 start date was 09/15/2025.

The following Type A deficiency is being cited on the attached LIC 809-D in accordance with Health & Safety Code (HSC) 1596.871(c)(1)(A) Fingerprints and criminal record information of individuals in contact with child day care facility clients...criminal records clearances, was issued. A civil penalty in the amount of $500.00 was issued today, 01/08/2026.



Facility representative was informed of the following: 1. Provide a copy of this report to the
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2026
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: NOBIS PRESCHOOL
FACILITY NUMBER: 304370149
VISIT DATE: 01/08/2026
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parents/authorized representatives currently enrolled by the next business day or immediately upon return. 2. A copy of this report shall also be provided to the parents/authorized representatives of any newly enrolled children for the next 12 months (1 year). 3. Obtain signature and date from the child's parents/authorized representatives on the Acknowledgement of Receipt of Licensing Reports (LIC9224). 4. Keep a record immediately upon receipt of the completed and signed LIC9224 acknowledging receipt of this report in the child's file.

Exit interview conducted and report was reviewed with the facility representative, Melinda Marchese. Appeal Rights were discussed with facility representative. The facility representative was provided a copy of the 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. A notice of site visit was given and must remain posted for 30 consecutive days. The “Notice of Site Visit” must be posted on, or immediately adjacent to, the interior side of the main door to the facility. Failure to post will result in Civil Penalties of $100.00.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/08/2026 03:04 PM - It Cannot Be Edited


Created By: Susan Deschampe On 01/08/2026 at 01:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: NOBIS PRESCHOOL
FACILITY NUMBER: 304370149

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/09/2026
Section Cited
HSC
1596.871(c)(1)(A)

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Subsequent to initial licensure, a person...shall obtain either a criminal record clearance or an exemption... prior to employment...facility.

This requirement is not met as evidenced by:
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Staff may not provide care to children until the criminal background clearance has been received by the Department.
Staff to complete livescan/fingerprinting.
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Observation, interview, and record review, the facility representative did not comply with the section cited above in 1 out of 4 staff files, which poses an immediate health, safety or personal rights risk to persons in care.
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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.
Thuy Ho
NAME OF LICENSING PROGRAM MANAGER:
Susan Deschampe
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2026


LIC809 (FAS) - (06/04)
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