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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020271
Report Date: 04/16/2021
Date Signed: 04/16/2021 09:28:22 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
02/25/2021 and conducted by Evaluator Lissete Gonzalez
COMPLAINT CONTROL NUMBER: 33-CC-20210225093355
FACILITY NAME:LAGUNA FAMILY CHILD CAREFACILITY NUMBER:
198020271
ADMINISTRATOR:EMILY H. LAGUNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 422-2176
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY:14CENSUS: 3DATE:
04/16/2021
UNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Emily LagunaTIME COMPLETED:
09:23 AM
ALLEGATION(S):
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Adults in home behave inappropriately in front of daycare children.
INVESTIGATION FINDINGS:
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At 9:03a.m. on April 16, 2021, Licensing Program Analyst (LPA) Lissete Gonzalez conducted a Complaint Inspection to conclude the investigation regarding the above complaint allegation. LPA contacted Licensee, Emily Laguna, via telephone due to COVID-19 precautionary measures. At 9:05a.m the call was transferred to Zoom to complete the tele-inspection. Licensee, Emily Laguna, guided LPA on a virtual tour of the facility. There were three (03) children present.

During the investigation, LPA reviewed records and conducted interviews with the Licensee, 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: 04/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021
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-20210225093355
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: LAGUNA FAMILY CHILD CARE
FACILITY NUMBER: 198020271
VISIT DATE: 04/16/2021
NARRATIVE
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Exit interview conducted with Licensee, Emily Laguna. Appeal Rights explained and provided. A 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: 04/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2