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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370910
Report Date: 04/08/2025
Date Signed: 04/08/2025 11:34:39 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
04/04/2025 and conducted by Evaluator Dean Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250404151536
FACILITY NAME:SAN JUAN MONTESSORIFACILITY NUMBER:
304370910
ADMINISTRATOR:SHARAN, SANDHYAFACILITY TYPE:
850
ADDRESS:32143 ALIPAZ STREETTELEPHONE:
(949) 496-2927
CITY:SAN JUAN CAPISTRANOSTATE: CAZIP CODE:
92675
CAPACITY:45CENSUS: 12DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Livia DiazTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility has pests
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Thompson conducted an unannounced complaint investigation on today’s date. Upon arrival LPA met with teacher Livia Diaz who stated she was in charge since the Director was not present. LPA observed 12 preschool age children with three preschool staff. The Orange County Child Care Office received a complaint on 4/4/2025, with one allegation listed above.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. 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.

During the investigation, LPA took pictures and interviewed three staff, and interviewed two children.

Continue to page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
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 3
Control Number 06-CC-20250404151536
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: SAN JUAN MONTESSORI
FACILITY NUMBER: 304370910
VISIT DATE: 04/08/2025
NARRATIVE
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Reporting Party (RP) mentioned observing cockroaches near the water bottle filling station located near the younger preschoolers' class.

On 4/8/2025, LPA observed the water bottle filing stations to be unplugged and placed on the outside play yard.

On 4/8/2025, LPA interviewed three staff. Two out of three staff interviewed stated they have observed cockroaches inside the classroom. One staff interviewed stated they have observed cockroaches on the outside play yard.

On 4/8/2025, LPA toured the facility inside and outside. LPA observed dead cockroaches inside primary classroom near the fish tank. Inside the toddler classroom, LPA observed dead cockroaches near the window frame and behind the fish tank on the floor.

On 4/8/2025, LPA interviewed two children. Children interviewed stated they have seen bugs/insects. Child #1 (C1) mentioned observing cockroaches and mosquitos near the fish tank inside the primary classroom. Child #2 (C2) mentioned observing spiders, crickets, and ants on the play yard.

Based on observation and staff stating they have observes cockroaches inside and outside on the play yard; the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division & Chapter 12, is being cited on the attached LIC 9099 D for the deficiency section 101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.

In the areas that were evaluated, one Type B deficiency was observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Livia Diaz.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20250404151536
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: SAN JUAN MONTESSORI
FACILITY NUMBER: 304370910
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/22/2025
Section Cited
CCR
101238(a)(1)
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101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.

This requirement was not met by:
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Submit proof of pest control report to LPA by POC due date.
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Based on LPA observation and interviews, the facility did not comply with the section cited above. Staff and children stated they have observes cockroaches inside the facility and outside on the play yard, which poses/posed 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: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3