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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198400479
Report Date: 07/28/2023
Date Signed: 07/28/2023 01:34:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 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
07/05/2023 and conducted by Evaluator Katrina Chicote
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20230705140059
FACILITY NAME:CHAN FAMILY CHILD CAREFACILITY NUMBER:
198400479
ADMINISTRATOR:CELEST CHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 610-2584
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:14CENSUS: 10DATE:
07/28/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Celest Chan, LicenseeTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Other - Licensee does not reside in the childcare home
INVESTIGATION FINDINGS:
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On 07/28/2023 at 11:35 AM LPA met with Celest Chan, Licensee, for the purpose of an Unannounced Complaint Inspection to deliver findings for the above allegation. Census was taken. LPA arrived during children's nap time and observed ten children napping on mats with three staff present at the facility.

During the course of the investigation, LPA obtained pertinent documents such as Facility Roster, copy of Licensee Driver's License, and copy of water bill. Documents reviewed reveal Licensee current address to be facility address. LPA conducted interviews with children and several adults relevant to case, interviews conducted provided conflicting information in regards to the allegation. Licensee states she lives in the licensed facility address and provided declaration at time of inspection.

Report Continues - Page 1 of 2
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
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-20230705140059
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CHAN FAMILY CHILD CARE
FACILITY NUMBER: 198400479
VISIT DATE: 07/28/2023
NARRATIVE
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This Agency has investigated the above complaint and found that although the allegation may have happened or is valid; based on observations and interviews there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the allegations are deemed
UNSUBSTANTIATED.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 07/28/2023.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensee, Celest Chan.


Report Ends - Page 2 of 2
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2