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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370970
Report Date: 09/22/2026
Date Signed: 09/22/2026 10:41:08 AM

Document Has Been Signed on 09/22/2026 10:41 AM - 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:KENSINGTON MONTESSORI SCHOOLFACILITY NUMBER:
304370970
ADMINISTRATOR/
DIRECTOR:		BLAILOCK, STACYFACILITY TYPE:
850
ADDRESS:29702 Kensington DRTELEPHONE:
(949) 363-7373
CITY:Laguna NiguelSTATE: CAZIP CODE:
92677
CAPACITY: 61TOTAL ENROLLED CHILDREN: 44CENSUS: 17DATE:
09/22/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:DirectorTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
NARRATIVE
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Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek conducted an onsite case management inspection for the purpose of a follow up for a few incidents happened at the facility and the facility self reported them to the department on 9/11/2026.

LPA met with director, Maria Oritiz. Census was taken. LPA observed a total of 4 toddlers with one staff in the toddler room (ages 18 months to 36 months old) and 17 preschool children with 2 staff on the playground. No children were in Sea Otter Room, and in Sea Turtle Room yet. They will transition to the classroom later on.

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.

The facility self reported the following unusual incidents to the department:

1- The facility was notified that 3-year-old Child # 1 (C1) disclosed that Staff # 1 (S1) got mad at C1 and hurt their arms on 9/9/2026. Photos were included showing red marks on both of their upper arms. It was reported that they were told by C1’s physician that they did appear to be finger/hand prints, the size of adult hands.
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Thuy Ho
Mahnaz Malek
DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2026
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: KENSINGTON MONTESSORI SCHOOL
FACILITY NUMBER: 304370970
VISIT DATE: 09/22/2026
NARRATIVE
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LPA interviewed 8 staff and 6 preschool children. Staff and children did not disclose that any staff person grabs children’s hands. LPA interviewed S1 who stated they held C1’s wrist to bring them to children’s lines when they were outside. S1 denied grabbing any child’s arm. No staff observed S1 grabs C1’s arm. The photos of C1’s upper arms were observed by LPA. C1 was taken to doctor the next day since C1 developed more rashes with red marks on the other parts of C1's body as well. Medical documentation did not indicate that the physician determined the redness was caused by a staff member grabbing or otherwise physically handling the child.

2- The facility reported that S2 was supervising children with S4 during nap time. C2 attempted to grab onto a bookshelf when S2 stopped C2 causing a hole on the back of C2’s clothing on 9/9/2026. Later on, the facility was informed that C2 disclosed S2 called them bad boy and weird.
LPA interviewed 8 staff and 6 preschool children. They did not disclose to LPA that anybody calls them anything inappropriate. S2 stated they sat by two cots between C2 and C3 and patted their backs, so they fell asleep. S4 was also in the room supervising napping children. C2 was struggling to take a nap. C2 jumped off their cot, stayed on their knees, looked like C2 was diving forward. S2 stated S2 was afraid C2 was going to hit their head on the corner of a shelf. They held C2’s shirt to stop C2 from getting hurt. S2 noticed a small rip under the tag of the back of the shirt. S2 stated they never said any inappropriate comments other than saying “do you want to grow big like your mommy and daddy” or "do you want to be a big child"? or "now is time to go to sleep". LPA interviewed S4 who was also in the room with S2 during this incident. S4 did not confirm S2 making any inappropriate comments. S4 stated C2 was lounging forward on the cot to push themselves forward. S4 did not see any holes in C2’s clothing.

3- The facility was informed that C1 was placed outside in the 102 degrees due to C1’s behavior on 9/9/2026. C1 developed rashes due to heat.
LPA interviewed 8 staff and 6 preschool children. They stated they don’t take children outside in the heat. LPA interviewed S1 who was supervising 9 preschool children on 9/9/2026. S1 stated S1 took children to air conditioning Multi Purpose Room to do activities after children rested and they did not want to nap. Then S1 took them to bathroom. C1 and other children were not listening or following S1’s instructions. S2 took them
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NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/22/2026 10:41 AM - It Cannot Be Edited


Created By: Mahnaz Malek On 09/22/2026 at 09:33 AM
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: KENSINGTON MONTESSORI SCHOOL
FACILITY NUMBER: 304370970

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2026
Section Cited
CCR
101223(a)(2)

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Personal Rights- To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. The above requirements was not met as evidenced by: Based on two self reported incidents by the facility, one incident C1 cut their bang with children’s scissors in the
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The director agreed to send a statement of a plan of correction in place to state that all the staff are aware of children's personal rights. The statement will include names of staff and their signatures acknowledging reviewing this section of regulation with them.
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classroom on 9/2/2026, and another incident that S1 took 9 preschool children outside on 9/9/2026 at 2:20 pm for 10 minutes in the outside weather of excessive heat conditions of 100-101 degrees Fahrenheit. This is a potential risk to the health and safety of children in care.
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The proof of correction will be sent to LPA's email address by the due date of 9/25//2026.

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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:
Mahnaz Malek
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2026


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: KENSINGTON MONTESSORI SCHOOL
FACILITY NUMBER: 304370970
VISIT DATE: 09/22/2026
NARRATIVE
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to the air-conditioning office to calm them down by talking to them for few minutes. They were brought back to the room and then S1 decided to take preschool children outside at 2:20 pm for water play on the playground at water sensory table. According to S1 they stayed outside for 10 minutes, and they came back in when S1 realized the weather was too hot. C1 was picked up at 2:30 pm. The medical record did not confirm that C1 had rashes by heat. However, the medical record documents the child’s history that the child’s representative gave them. LPA searched and found out that the outside weather temperature for Orange County, Laguna Niguel area was 100-101 Degrees Fahrenheit on 9/9/2026 at 2:20 pm. This is a personal rights violation that is cited today under section 101223(a)(2).

4- C1 cut their hair in the classroom while C1 was under supervision of S1 on 9/2/2026. S1 admitted that C1 was interested in scissors activities. C1 was given children’s scissors and C1 cut their bang when C1 was not looking. S1 stated S1 was close to C1 and under supervision. This is a personal rights violation that is cited today under section 101223(a)(2).

Based on LPA’s interviews with 8 staff and 6 preschool children and reviewing medical records for C1 and additional information, two incidents were involved in the personal rights of children in care. Please refer to next page LIC 809D for detail of deficiency.

A notice of site visit was given to director, Maria Ortiz and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview was conducted with director, Maria Ortiz.

End of report.

NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC809 (FAS) - (06/04)
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