304371547-9-20-2026-06-CC-MMAK-DXYS87-20260916133841

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371547
Report Date: 09/16/2026
Date Signed: 09/20/2026 05:58:16 PM

Document Has Been Signed on 09/20/2026 05:58 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:	ORANGE TREE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	304371547
ADMINISTRATOR/ DIRECTOR:	DAVIS, SAVANNAH		FACILITY TYPE:	850
ADDRESS:	2115 Newport BLVD		TELEPHONE:	(949) 458-1382
CITY:	Costa Mesa	STATE: CA	ZIP CODE:	926271703
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 34	CENSUS: 23	DATE:	09/16/2026
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	New director Jenna Tashima		TIME VISIT/ INSPECTION COMPLETED:	02:00 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	Page 1 of 4 Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite inspection for the purpose of an Annual inspection. LPA met with new director, Jenna Tashima who gave LPA a tour of the facility. The director's packet has been submitted to our office. The preschool is located on the ground of Crossing Church. Census was taken. A total of 23 preschool children with 4 staff in 2 different classrooms and on the playground observed. The teacher child ratio was as below: One staff with 7 preschool children in Room 101, one staff with 9 children belong to Room 102 who were transitioning from playground to inside the building, one staff with 7 preschool children in Room 102. Room 103 was not currently in use. Room 104 has a waiver approval for children's activity room on occasions. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:30 am - 6:00 pm., Monday through Friday. Parents sign their children in and out electronically using the Pro Care Application. 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 inspection of the indoor activity space, items which could pose a danger to children (cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. The facility provides morning/afternoon snacks, and lunches are provide to children by their parents. Menu is posted. Floors, equipment, and furniture were clean and were observed Continue to page 2

Thuy Ho
Mahnaz Malek
	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ORANGE TREE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304371547
	VISIT DATE: 09/16/2026

NARRATIVE

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to be in good repair and free of sharp edges. Drinking water is available to children indoors by water containers that children bring from home and the facility fills them up with filtered water if need to. Preschool children nap on mats. Beddings are provided by parents and are sent home to be washed on a daily basis.

Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges. Drinking water is available to children indoors by water containers children bring from home and the facility fills them up at the facility if needed.

The facility has conducted an emergency drill within the past six months, last fire drill was conducted on 6/10/202. The facility has Carbon Monoxide Detector.

The outdoor activity space was inspected for compliance. There are two separate playgrounds for preschool children which were enclosed by a fence at least four feet in height. The surface of the outdoor activity space were well maintained and free of hazards. The surface of the outdoor activity area for two playgrounds were covered with cushioning materials such as artificial grass (Turf). There were one entrance gate from the courtyard to the playground and one exit gate to the parking lot which were closed and equipped with alarm devices. They were tested and alarm devices were operable. The transitioning of younger preschool children from the classrooms to the playground located in the courtyard of the church are provided by children's buggy. The transitioning of older preschool children is by walking and escorting by the staff. LPA also observed a water fall with collecting water at the entrance of the open area of the church.

Drinking water in the outdoor activity space is provided by water containers which facility fills them up at the facility if needed. The outdoor equipment and toys were in good repair and free of sharp edges. Shade is provided. There is a baptismal pool located in the courtyard of the church. LPA observed the baptismal pool was empty and drained of water in the courtyard of the church building. Security net is secured with latched imbedded in the ground and the security cover is able to hold the weight of an adult person. This was observed by LPA that an adult passed through the strong net cover from one side to another side of the empty baptismal pool. Children walk while escorted by the staff on the side walk along the building and cross the courtyard at the end walk through the walkway leading to the play yard.
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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC809 (FAS) - (06/04)

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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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ORANGE TREE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304371547
	VISIT DATE: 09/16/2026

NARRATIVE

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4 staff files were reviewed for staff present during the facility inspection on this date. They were in compliance. A random sample of 5 children's files were reviewed for documentation of the child’s name, address, and they were in compliance.

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 as specified in Health and Safety Code Section 1597.16. For child care 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). LPA verified that the lead testing completed accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA verified that the lead testing was not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information
(https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

Incidental Medical Service (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provide, a plan for providing IMS must be submitted to the Department. 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 informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The director, Jenna Tashima was reminded that all adults 18 and over including employees and volunteers, except as specified in Health and Safety Code Section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC809 (FAS) - (06/04)

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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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ORANGE TREE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304371547
	VISIT DATE: 09/16/2026

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspection process@ dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website athttps://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Jenna Tashima.

In the areas that were evaluated, the following deficiency was cited of the California Code of Regulations, Title 22, Division 12 on this inspection day. Please refer to LIC 809D for details of deficiency.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/20/2026 05:58 PM - It Cannot Be Edited

Created By: Mahnaz Malek On 09/16/2026 at 01:12 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: ORANGE TREE CHRISTIAN PRESCHOOL	FACILITY NUMBER: 304371547
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/16/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in one count out of one count of not having the water tested for lead which poses a potential health, and safety risk to persons in care.
	POC Due Date: 10/16/2026
	Plan of Correction
1 2 3 4	The director agreed to have their water tested and the result will be sent to LPA's email address on or before the due date of 10/16/2026.

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.

	Thuy Ho
NAME OF LICENSING PROGRAM MANAGER:

	Mahnaz Malek
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC809 (FAS) - (06/04)

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