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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304314382
Report Date: 03/03/2026
Date Signed: 03/03/2026 03:41:57 PM

Unsubstantiated


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
12/26/2025 and conducted by Evaluator Long Pham
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20251226102918
FACILITY NAME:HOLLAND, JACQUELINEFACILITY NUMBER:
304314382
ADMINISTRATOR:HOLLAND, JACQUELINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 689-9971
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY:14CENSUS: 0DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee Holland Jacqueline TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Licensee is operating over capacity.
INVESTIGATION FINDINGS:
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On 03/03/2026 at 1:00pm, Licensing Program Analysts (LPAs) Long Pham and Dean Thompson conducted an unannounced complaint inspection for the purpose of delivering findings. Upon arrival, LPAs met with the Licensee Holland Jacqueline and an assistant Fante Paris and were led on a tour of the facility. LPAs observed zero children in care. This is a continuation of a complaint inspection initiated on 12/30/2025.

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 12/26/2025, the Orange County Child Care Office received a complaint alleging Licensee is operating over capacity. Reporting Party (RP) stated that the Licensee is planning to combine two previously separate preschool program locations into a single licensed family child care home location.
Page 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Long Pham
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/03/2026
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 2
Control Number 06-CC-20251226102918
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: HOLLAND, JACQUELINE
FACILITY NUMBER: 304314382
VISIT DATE: 03/03/2026
NARRATIVE
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RP stated that one location is currently operated with approximately 15 children present on Mondays; combining both programs would result in approximately 28 children present at the same time. RP indicated that this appears to exceed the licensed capacity for the current license type and may require additional licensing that is not held.
During the investigation, LPAs toured the facility and obtained pertinent documents. LPAs also conducted interviews with the Reporting Party, 6 staff members, and 5 parents. LPAs did not interview children because there are no children in care.
Regarding the allegation of “Licensee is operating over capacity”

During the staff interview, Staff # 1 (S1), Staff # (S2), and Staff # 3 denied the allegation and stated that the facility never operated out of ratio. They stated that they usually work with two other assistants and the Licensee when they are supervising about 10 to 12 children; they never work by themselves. LPA tried to contact Staff # 4 (S4), Staff # 5 (S5), and Staff # 6 (6), and they never returned LPA’s call. LPA attempted to request the roster for December 2025 and January 2026, but Licensee did not provide. The licensee has provided the February 2026 roster, showing 12 children scheduled per day, Monday through Friday.

During the initial 10-day visit, LPAs did not observe any children in care. During the parent interview, all 5 interviewed parents did not divulge any information pertaining to the allegation or express any concerns regarding care of the children.

Based on LPAs' observations, interviews, and records review, the preponderance evidence of Licensee is operating over capacity has not been met. 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 was conducted and report was reviewed with the Facility Representative Holland Jacqueline.

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. Page 2 of 2

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

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

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