304370087-9-3-2026-06-CC-TNGN-DXYPL4-20260916112409

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370087
Report Date: 09/03/2026
Date Signed: 09/03/2026 03:55:11 PM

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
07/10/2026 and conducted by Evaluator Sarah Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20260710100236

FACILITY NAME:	PLACENTIA HEAD START		FACILITY NUMBER:	304370087
ADMINISTRATOR:	GOMEZ, MANUEL		FACILITY TYPE:	850
ADDRESS:	840 SOUTH MELROSE		TELEPHONE:	(714) 632-8787
CITY:	PLACENTIA	STATE: CA	ZIP CODE:	92870
CAPACITY:	60	CENSUS: 40	DATE:	09/03/2026
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Director, Manuel Gomez		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Physical Plant-Staff do not ensure daycare center is free of insects.

INVESTIGATION FINDINGS:

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*This is an amended verison of the original report dated 9/3/2026*
On 9/3/2026, Licensing Program Analyst (LPA) Sarah Garcia conducted an unannounced complaint inspection to deliver the findings for the above allegation. This is a continuation of the investigation initiated on 7/10/26. Upon arrival, LPA met with Director, Manuel Gomez. Director guided LPA on a walkthrough of the facility and took a census. LPA observed the facility during nap time and the total census was 40 preschool children and 6 staff.
A review of staff criminal clearance records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint on 07/08/2026 alleging staff do not ensure daycare center is free of insects.
Continued on Page 2

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

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 5

Control Number 06-CC-20260710100236

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: PLACENTIA HEAD START	FACILITY NUMBER: 304370087
	VISIT DATE: 09/03/2026

NARRATIVE

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The Reporting Party (RP) stated the center is infested with cockroaches and cockroaches have been seen in the kitchens and classrooms.

During the investigation, LPA Garcia interviewed staff, and children’s authorized representatives, obtained menus, facility pest control documentation and children’s roster.

All staff interviewed stated they have observed insects in the classrooms and near the hallways.

LPA received photos of insects in classroom two and in the facility hallways. On 7/10/2026 LPA observed the classrooms and observed them to be clean and orderly; no visible insects were observed at the time of inspection.

Throughout the investigation, LPA interviewed children’s authorized representatives. Representatives interviewed made no disclosures regarding the allegation.

Based on record review and interviews, it has been determined that staff do not ensure daycare centers are free of insects. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101238(a)(1) Buildings and Grounds is being cited on the attached LIC 9099D. LPA provided director with the Title 22 regulations Sections 101238 for reference.

Exit interview conducted and report was reviewed with the director, Manuel Gomez.

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.

End of Report.

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 06-CC-20260710100236

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: PLACENTIA HEAD START	FACILITY NUMBER: 304370087
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/03/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/17/2026 Section Cited CCR 101238(a)(1)	1 2 3 4 5 6 7	Section 101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair...(1) The...take measures to keep the center free of flies, other insects, and rodents. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Beginning 07/15/2026, the Orange County Head Start agency contracted Neighborly Pest Control to conduct bi-weekly pest control services on facilities.
	8 9 10 11 12 13 14	Based on interview and record review, the facility did not ensure the center was free from insects which poses a potential health and safety rights risk to children in care.	8 9 10 11 12 13 14
	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.

SUPERVISOR'S NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

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
07/10/2026 and conducted by Evaluator Sarah Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20260710100236

FACILITY NAME:	PLACENTIA HEAD START		FACILITY NUMBER:	304370087
ADMINISTRATOR:	GOMEZ, MANUEL		FACILITY TYPE:	850
ADDRESS:	840 SOUTH MELROSE		TELEPHONE:	(714) 632-8787
CITY:	PLACENTIA	STATE:CA	ZIP CODE:	92870
CAPACITY:	60	CENSUS: 40	DATE:	09/03/2026
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Director, Manuel Gomez		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Food Service-Staff do not ensure food service preparation requirements are followed.

INVESTIGATION FINDINGS:

1
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3
4
5
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7
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9
10
11
12
13

*This is an amended verison of the original report dated 9/3/2026*
On 9/3/2026, Licensing Program Analyst (LPA) Sarah Garcia conducted an unannounced complaint inspection to deliver the findings for the above allegation. This is a continuation of the investigation initiated on 7/10/26. Upon arrival, LPA met with Director, Manuel Gomez. Director guided LPA on a walkthrough of the facility and took a census. LPA observed the facility during nap time and the total census was 40 preschool children and 6 staff.
A review of staff criminal clearance records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint on 07/08/2026 alleging staff do not ensure food service preparation requirements are followed.
Continued on Page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 06-CC-20260710100236

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: PLACENTIA HEAD START	FACILITY NUMBER: 304370087
	VISIT DATE: 09/03/2026

NARRATIVE

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The Reporting Party (RP) stated the food that is prepared off site is brought to the center and is left out for hours.

During the investigation, LPA Garcia interviewed staff, and children’s authorized representatives, obtained menus, facility pest control documentation and children’s roster.

All staff interviewed stated they have not observed the prepared food being left out for extended periods of time.

Throughout the investigation, LPA interviewed children’s authorized representatives. Representatives interviewed made no disclosures regarding the allegation.

Based on interviews and record review, the allegation that staff do not ensure food service preparation requirements are followed is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted and report was reviewed with the Director, Manual Gomez.

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.

End of Report.

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 5