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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198014584
Report Date: 12/04/2019
Date Signed: 12/04/2019 10:29:56 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 CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/13/2019 and conducted by Evaluator Susann Sanchez
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20190913110948
FACILITY NAME:CELIS FAMILY CHILD CAREFACILITY NUMBER:
198014584
ADMINISTRATOR:CELIS, KELLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 429-9646
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY:14CENSUS: 11DATE:
12/04/2019
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Kelly Celis, LicenseeTIME COMPLETED:
09:55 AM
ALLEGATION(S):
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Licensee left children unattended.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Susann Sanchez arrived at the above facility for the purpose of deliver the findings of the complaint allegation above. LPA met with Licensee Kelly Celis and toured the facility. There are 11 day-care children present (9 children, 1 infant, and 1 school-aged child). LPA observed proper care and supervision.

During the course of the investigation LPA interviewed, Licensee, staff, parents, and children there were no disclosures made. There were serval attempts to interview complainant, however, LPA was unable to reach complainant during this investigation. Complainant stated that she/he witnessed an adult who was talking to other adults and not watching the children at the elementary school nearby. Based on the evidence obtained during the course of the investigation through interviews, observation, and record reviews (daily sign in sheets) the evidence does not support.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
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 54-CC-20190913110948
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CELIS FAMILY CHILD CARE
FACILITY NUMBER: 198014584
VISIT DATE: 12/04/2019
NARRATIVE
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There were no witnesses observed such incidents happened at the facility therefore, the allegations have been determined unsubstantiated. Unsubstantiated – means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Kelly Celis, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2