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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605308
Report Date: 07/29/2026
Date Signed: 07/29/2026 11:28:50 AM

Document Has Been Signed on 07/29/2026 11:28 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CSUF CHILDREN CENTERFACILITY NUMBER:
300605308
ADMINISTRATOR/
DIRECTOR:		LYDIA PALACIOSFACILITY TYPE:
850
ADDRESS:800 N.STATE COLLEGE BLVD.T-200TELEPHONE:
(657) 278-2961
CITY:FULLERTONSTATE: CAZIP CODE:
92834
CAPACITY: 88TOTAL ENROLLED CHILDREN: 78CENSUS: 44DATE:
07/29/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Director, Lydia PalaciosTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 07/29/2026 at 9:05am, Licensing Program Analyst (LPA) Sarah Garcia conducted a case management- incident visit in response to a self-reported unusual incident report (LIC 624) received on 07/12/26 regarding alleged violation of child's personal rights. LPA met with director, Lydia Palacios. A walk through of the facility was conducted, and census was taken. Total census was 44 preschool children and 13 staff.

A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 7/12/2026, a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 7/9/2026, Child 1 (C1) reported that Staff 1 (S1) slapped them on the forearm. C1 stated S1 slapped them in the restroom. C1 stated that S1 told them to pick up the underwear and C1 did not listen so S1 hit them. Per diaper logs at 12:30pm, S1 interacted with C1 during a potty session. Staff 2 (S2) was present during the 12:30pm potty session and did not observe S1 hit C1.

During today's inspection, LPA Garcia interviewed 4 staff, 1 adult, and obtained C1's identification form (LIC 700), 7/9/26 sign in/out sheets for butterfly room, internal investigation report, 7/9/26 diaper logs, personnel record, and children's roster. LPA did not interview C1 due to them not being present during today's visit.

Due to additional information needed, the reported incident needs further investigation.

Exit interview conducted and report was reviewed with Program Coordinator, Deisy Hernandez, Assistant Director, Sonia Nunez, and Director, Lydia Palacios. A notice of site visit was given and must remain posted for 30 days.

Tina Nguyen
Sarah Garcia
DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2026
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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