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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371682
Report Date: 05/18/2026
Date Signed: 05/18/2026 05:32:56 PM

Document Has Been Signed on 05/18/2026 05:32 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:HERITAGE HILL KINDERCAREFACILITY NUMBER:
304371682
ADMINISTRATOR/
DIRECTOR:		BROWN, BARBARAFACILITY TYPE:
860
ADDRESS:21791 LAKE FOREST DRIVETELEPHONE:
(949) 344-6951
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 108TOTAL ENROLLED CHILDREN: 80CENSUS: 67DATE:
05/18/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Facility Representative, Barbara BrownTIME VISIT/
INSPECTION COMPLETED:
06:45 PM
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On 05/18/2026, Licensing Program Analyst (LPA) Deschampe conducted a case management inspection in response to a self-reported unusual incident report (UIR)(LIC 624) received on 04/17/2026, regarding alleged lack of supervision. This is a continuation of the investigation initiated on 04/21/2026. LPA was allowed entry to the facility at 1:55PM and met with the facility representative/director (FR), Barbara Brown. FR guided LPA through the facility with the following census: Total enrollment 80 children, with a census of 67 napping children with 13 staff.

On 04/17/2026, the UIR was filed with the Orange County Regional Office (OCRO) to self-report an incident from 04/16/2026 at 5:25PM. Staff 8 (S8) and Staff 2 (S2) were transitioning 5 children from the Toddler room to the Infant room. While transitioning, Child 1 (C1) had walked away from the group. Staff 1 (S1) left the Infant room and found C1 at a buggy with no staff. S1 took C1 back to the Infant room. C1 was away from the group for about 2 minutes. The FR was notified and followed up with staff. The FR informed the parent of the incident. On 04/17/2026, the FR observed and worked with staff during transitions.

Throughout the investigation, LPA interviewed 10 staff, parent(s)/authorized representative(s), and attempted to interview C1. LPA obtained the Personnel Report (LIC500), facility break sheet, Child Supervision Record (CSR), Facility Staff Meeting/Training Agenda (04/23/2026) and staff meeting/training sign-in sheet. LPA observations completed on 04/21/2026 and 05/18/2026.

During the staff interviews, S1 confirmed C1 was found in the hallway, in between the buggies, approximately 35 feet from the Infant C room. S1 confirmed there was no staff present. S1 confirmed no parent/authorized representative was present, after checking nearby classrooms. On 04/23/2026, the facility representative/director trained all staff on transitioning protocol, including the use of buggies or walking rope,

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2026
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 4
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: HERITAGE HILL KINDERCARE
FACILITY NUMBER: 304371682
VISIT DATE: 05/18/2026
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re-train on completing proper steps on the CSR document (completion at thresholds, at designated times throughout the day, CSR management checks 2 times per day), re-train staff to consistently complete mental counts, and active supervision of where staff should be (indoor, outdoor, and transitions).

LPA attempted to interview C1 using the Ten Step Investigative Interview but C1 did not qualify for an interview.

LPA observed on 04/21/2026 and 05/18/2026, the facility staff engaging in transitioning protocol including CSR protocols and the use of buggies.

Based on LPA’s interviews, observation, and record review, there was adequate evidence to support the lack of supervision. California Code of Regulations, Title 22 Division 12 Chapter 1, Section 101429(a)(1) Responsibility for Providing Care and Supervision for Infants is being cited on the attached LIC 809D. This is a repeat violation, within 12 months, therefore $250 will be assessed today.

LPA informed facility representative, Barbara Brown, this report dated 05/18/2026 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. LPA informed facility representative to provide a copy of this licensing report dated 05/18/2026 that documents the Type A citation to parents/authorized representatives 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.



The exit interview was conducted with the facility representative, Barbara Brown. The Notice of Site Visit was posted during the visit. The facility representative was reminded that the Notice of Site Visit must be posted for 30 consecutive days. Appeal Rights were discussed and provided to the facility representative and their signature on this form acknowledges receipt of these rights. Licensee must file an appeal, in writing, to the Regional Manager within 15 business days from the date of receiving the penalty assessment or notice of deficiency. First level appeals should be sent to the Regional Manager at the address listed above. End of report.
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Susan Deschampe
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/18/2026 05:32 PM - It Cannot Be Edited


Created By: Susan Deschampe On 05/18/2026 at 03:54 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: HERITAGE HILL KINDERCARE
FACILITY NUMBER: 304371682

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/18/2026
Section Cited
CCR
101429(a)(1)

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101429(a)(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.

This requirement is not met as evidenced by:
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Transitioning protocol (effective 04/23/2026)
LIC9224 to be sent/given to parents/authorized representatives.
This is a repeat violation, within 12 months, therefore $250 will be assessed.

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Based on S1 interview, S1 confirmed finding C1 without facility staff or parent/authorized representative supervision in the hallway. This 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: 05/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2026


LIC809 (FAS) - (06/04)
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