304371499-12-9-2024-06-CC-DTHN-DBT3A6-20241209170414

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371499
Report Date: 12/09/2024
Date Signed: 12/09/2024 05:04:21 PM

Document Has Been Signed on 12/09/2024 05:04 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KIDDIE ACADEMY OF MISSION VIEJO		FACILITY NUMBER:	304371499
ADMINISTRATOR/ DIRECTOR:	CHRISTINA NAFFZIGER		FACILITY TYPE:	850
ADDRESS:	25521 MUIRLANDS BLVD.		TELEPHONE:	(949) 380-6868
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY: 120	TOTAL ENROLLED CHILDREN: 105	CENSUS: 66	DATE:	12/09/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Christina Naffziger		TIME VISIT/ INSPECTION COMPLETED:	05:30 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	Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced case management incident inspection in response to a self reported Unusual Incident dated 11/26/2024. LPA met with Director Christina Naffziger and toured the facility. LPA observed 66 preschool age children with nine staff. A review of the Facility Personnel Report Summary on this 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 visit, it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. On 11/26/2024, a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported a child being left unattended without any supervision inside the restroom for approximately 8 to 10 minutes on 11/25/2024. Director reported at approximately 4:30 pm, census inside classroom #117 had 17 children with 2 staff. When the incident occurred, children were getting ready to go outside. Child #1 (C1) was using the restroom, when staff #1 (S1) and staff #2 (S2) failed to conduct name to face correctly. S1 and S2 went outside with the children and leaving C1 alone while inside the restroom. Staff #3 (S3) was next door and heard crying. S3 walked into classroom #117 and observed C1 crying in the restroom alone. Director stated when S1 and S2 realized C1 was not outside, S3 and Director were already with C1. Director stated child was left in the restroom unsupervised for about 8 to 10 minutes. Continue to page 2

Judy Hanson	TELEPHONE: (714) 795-0415
Dean Thompson	TELEPHONE: (714) 287-0708
	DATE: 12/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024

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 3

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: KIDDIE ACADEMY OF MISSION VIEJO	FACILITY NUMBER: 304371499
	VISIT DATE: 12/09/2024

NARRATIVE

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Based on interviews, it was revealed that child (C1) was left alone on 11/25/2024, without any adult supervision inside the restroom for approximately 8 to 10 minutes. The following violation Responsibility for providing care and supervision was revealed today and is being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101229 (a)(1) . Please see the attached LIC 809D.

LPA Thompson informed Director Christina Naffziger that this report dated 12/9/2024 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed Director Christina Naffziger to provide a copy of this licensing report dated 12/9/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Christina Naffziger. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Appeal Rights and deficiencies were discussed. The facility representative was provided 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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 795-0415
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 12/09/2024 05:04 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: KIDDIE ACADEMY OF MISSION VIEJO	FACILITY NUMBER: 304371499
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time.... Supervision shall include visual observation. This requirement was not met by:
	Deficient Practice Statement
1 2 3 4
	POC Due Date: 12/09/2024
	Plan of Correction
1 2 3 4	Director stated they have completed name to face training.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Judy Hanson	TELEPHONE: (714) 795-0415
Dean Thompson	TELEPHONE: (714) 287-0708
	DATE: 12/09/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024

LIC809 (FAS) - (06/04)

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