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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270533
Report Date: 03/10/2026
Date Signed: 03/10/2026 11:39:19 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/07/2026 and conducted by Evaluator Long Pham
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20260107095020
FACILITY NAME:BUENA PARK HEAD STARTFACILITY NUMBER:
304270533
ADMINISTRATOR:CELIA FRANCOFACILITY TYPE:
850
ADDRESS:6725 DALE STREETTELEPHONE:
(714) 521-1909
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:60CENSUS: 27DATE:
03/10/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Wendolin HernandezTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility did not report incident to CCL.
INVESTIGATION FINDINGS:
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On 03/10/2026, Licensing Program Analyst (LPA) Long Pham conducted an unannounced complaint inspection for the purpose of delivering findings. Upon arrival at 9:05am, LPA met with the director Wendolin Hernandez and was led on a tour of the facility. LPA observed a total of 27 preschool children with 9 staff. This is a continuation of a complaint inspection initiated on 01/08/2026.

A review of the Facility 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 today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios.
On 01/07/2026, the Orange County Child Care Office received a complaint alleging Facility did not report incident to CCL. The Reporting Party (RP) stated that on 09/18/2025, Staff #1 (S1) and Staff #6 (S6) were in the classroom from 5:00 PM to 5:30 PM until closing. Parent #6 (P6) arrived to pick up Child #2 (C2), who had a bowel movement, and P6 asked staff to change C2.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Long Pham
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 06-CC-20260107095020
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: BUENA PARK HEAD START
FACILITY NUMBER: 304270533
VISIT DATE: 03/10/2026
NARRATIVE
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Staff #1 (S1) left the classroom to take C2 to the bathroom alone. RP reported that Child #1 (C1) ran out of Classroom #3, down the hallway, past the front office area, and out the front door of the portable building into the parking lot. The RP stated that Staff #6 (S6) asked Parent #6 (P6) to remain in the classroom with the children and notify S1 while S6 went to retrieve C1. S6 ran outside to bring C1 back inside, and at that time, C1 was already in the parking lot. RP stated that the facility did not report any incident that occurred on September 18, 2025, to Licensing.

During the investigation, LPA toured the facility and obtained pertinent documents. LPA also conducted interviews with the reporting party, 5 staff members, 6 parents, and 5 children.



Regarding the allegation of “Facility did not report incident to CCL.”

During the staff interview, Staff #1 (S1), and Staff #5 (S5) confirmed that they knew about the incident C1 ran out of classroom #3 and into the parking lot. S1 shared that S6 reported the incident to director. The facility director stated that she reported the incident to C1’s authorized representative and her manager. The Director stated that the facility did not report the incident that occurred on September 18, 2025 to Licensing because there was no injury involved in the incident.



During the parent interview, all 6 interviewed parents did not divulge any information pertaining to the allegation or express any concerns regarding care of the children. LPA reviewed the file and did not find any Unusual Incident Report regarding the incident on 09/18/2025 reported to Licensing.

Based on LPA’s interviews, and records review, the preponderance evidence of Facility did not report incident to CCL has been met; Therefore, the allegation of Facility did not report incident to CCL was found to be Substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1 Reporting Requirements 101212(d)(1)(C) is being cited. See LIC9099D for deficiency cited.

Exit interview was conducted and report was reviewed with the facility representative Wendolin Hernandez.

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SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Long Pham
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 06-CC-20260107095020
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: BUENA PARK HEAD START
FACILITY NUMBER: 304270533
VISIT DATE: 03/10/2026
NARRATIVE
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Notice of Site Visit was posted during the visit. The facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

Appeal Rights were explained. The facility representative was provided with a copy of the appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

End of Report.

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SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Long Pham
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20260107095020
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: BUENA PARK HEAD START
FACILITY NUMBER: 304270533
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/26/2026
Section Cited
CCR
101212(d)(1)(C)
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101212 Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. This requirement was not met evidenced by:
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The director will review the Reporting Requirement with all staff and have them sign the acknowledgement form. The director will email the acknowledgement form to LPA by 3/16/2026.
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Based on LPA's interviews, and records review, the licensee did not comply with the section cited above due to the director stated that the facility did not report the incident that occurred on September 18, 2025 to Licensing because there was no injury involved in the incident. Plus, LPA reviewed the file and did not find any Unusual Incident Report regarding the incident on 09/18/2025 reported to Licensing which poses a potential 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.
SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Long Pham
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC9099 (FAS) - (06/04)
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