364815787-7-28-2026-09-CC-ERAS-DWETXS-20260728150737

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364815787
Report Date: 07/28/2026
Date Signed: 07/28/2026 03:07:53 PM

Document Has Been Signed on 07/28/2026 03:07 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MAOF FREMONT PRESCHOOL		FACILITY NUMBER:	364815787
ADMINISTRATOR/ DIRECTOR:	CLAUDIA ESPINOZA		FACILITY TYPE:	850
ADDRESS:	9950 FREMONT AVENUE		TELEPHONE:	(909) 626-1092
CITY:	MONTCLAIR	STATE: CA	ZIP CODE:	91763
CAPACITY: 72	TOTAL ENROLLED CHILDREN: 72	CENSUS: 35	DATE:	07/28/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:42 PM
MET WITH:	Claudia Espinoza		TIME VISIT/ INSPECTION COMPLETED:	03:18 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 the date and time listed, Licensing Program Analyst (LPA) Eric Ramos arrived at the facility for the purpose of conducting a Case Management inspection in response to the receipt of an Unusual Incident Report (UIR) that was submitted by the facility on 07/23/2026. LPA was granted entry into the facility by Claudia Espinoza. LPA explained the purpose of today's inspection, completed a facility tour, obtained census and interviewed pertinent parties. On 07/22/2026, the facility self reported that a child was left alone in the restroom for approximately less than one minute. It was reported that Staff 1 observed Staff 2 escorting four children to use the restroom located by the playground. Information revealed that Staff 2 was returning to the classroom with only three children. Furthermore, Staff 1 went to check the restroom and observed the child alone washing their hands. The child told Staff 1 that Staff 2 had forgot about them and left them alone in the restroom. The child was then escorted safely back to the classroom by staff. Based on information obtained during the investigation, it has been determined there is a violation of Title 22 Regulations pertaining to the reported incident at this time. See LIC809-D for cited deficiency. A Civil Penalty has been issued in the amount of $250.00 due to repeat violation being cited within 12 months. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

Ana Noble
Eric Ramos
	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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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Document Has Been Signed on 07/28/2026 03:07 PM - It Cannot Be Edited

Created By: Eric Ramos On 07/28/2026 at 02:25 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAOF FREMONT PRESCHOOL	FACILITY NUMBER: 364815787
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/28/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/29/2026 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	(1) No child(ren) shall be left without the supervision of a teacher at any time.... Supervision shall include visual observation. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Facility agrees to hold a meeting where visual observation will be addressed and by completing a training regarding expectations for supervision with all staff. Facility will also submit an attendance sheet of staff who were present during the meeting with proof of staff(s) signature.
	8 9 10 11 12 13 14	Based on interviews and a self-report from the facility, staff did not maintain visual supervision of a child for approximately 1 minute which poses/posed an immediate health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14	Facility will provide a plan of action on how they will execute maintaining constant supervision. An immediate civil penalty of $250.00 has been assessed on today's visit.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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

	Ana Noble
NAME OF LICENSING PROGRAM MANAGER:

	Eric Ramos
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAOF FREMONT PRESCHOOL	FACILITY NUMBER: 364815787
	VISIT DATE: 07/28/2026

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LPA Ramos informed Director Claudia Espinoza that this report dated 07/28/2026 document(s) 1 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 Ramos informed Director Claudia Espinoza to provide a copy of this licensing report dated 07/28/2026 that documents any Type A citation(s) to parents 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.

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. Exit interview conducted and report was reviewed with Director Claudia Espinoza.

NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC809 (FAS) - (06/04)

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