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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191871630
Report Date: 05/27/2021
Date Signed: 05/27/2021 10:07:08 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2021 and conducted by Evaluator Lissete Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20210429085158
FACILITY NAME:LA MIRADA HEAD STARTFACILITY NUMBER:
191871630
ADMINISTRATOR:MARCIE HOUCHENFACILITY TYPE:
850
ADDRESS:5637 LA MIRADA AVE.TELEPHONE:
(323) 464-6982
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY:75CENSUS: 35DATE:
05/27/2021
UNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Abigail Saucedo, Center ManagerTIME COMPLETED:
10:04 AM
ALLEGATION(S):
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Staff yell at children while in care.
INVESTIGATION FINDINGS:
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At 9:38a.m. on May 27, 2021, Licensing Program Analyst (LPA) Lissete Gonzalez conducted a Complaint Inspection to conclude the investigation regarding the above complaint allegation. LPA contacted Center Manager, Abigail Saucedo, via telephone due to COVID-19 precautionary measures. At 9:41a.m the call was transferred to Zoom to complete the tele-inspection. Center Manager, Abigail Saucedo, guided LPA on a virtual tour of the facility. There were thirty-five (35) children present.

During the investigation, LPA reviewed records and conducted interviews with staff and other witnesses. There were no disclosures made during any interview to corroborate the above allegation. 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.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's tele-inspection
REPORT CONTINUES ON NEXT PAGE: 1 OF 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021
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 33-CC-20210429085158
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LA MIRADA HEAD START
FACILITY NUMBER: 191871630
VISIT DATE: 05/27/2021
NARRATIVE
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Exit interview conducted with Center Manager, Abigail Saucedo. Appeal Rights explained and provided. A of copy the report (LIC 9099) and Appeal Rights (LIC 9058) were sent via email to the Licensee. An electronic read receipt confirms receipt of the reports. The facility representative was provided with the mailing address to the Monterey Park Regional Office (1000 Corporate Center Drive, Suite 200B, Monterey Park, CA 91754) and agrees to send a copy of the signed LIC 9099 reports by email to LPA Gonzalez and mail the original forms to the regional office.

END OF REPORT: PAGE 2 OF 2
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3383
LICENSING EVALUATOR NAME: Lissete GonzalezTELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2