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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376627917
Report Date: 03/10/2022
Date Signed: 03/10/2022 01:26:53 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/22/2021 and conducted by Evaluator Grace Curtis
COMPLAINT CONTROL NUMBER: 51-CC-20211222123034
FACILITY NAME:PAGAN, NINA FAMILY CHILD CAREFACILITY NUMBER:
376627917
ADMINISTRATOR:NINA PAGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 940-8993
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:14CENSUS: 12DATE:
03/10/2022
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Nina PaganTIME COMPLETED:
12:44 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Sexual Abuse
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On March 10, 2022 at 12:25 p.m. Licensing Program Analyst Leilani Curtis conducted an unannounced inspection for the purpose of delivering the findings for the above allegation. Upon arrival LPA met with Licensee, Nina Pagan. Also present were the licensee’s helpers Ann Naibova and Garegin Naibov, and 12 children. One child was under 24 months.

The complaint was investigated by the Department of Social Services Investigations Branch. Based on the information obtained by the Investigations Branch, there was insufficient evidence to conclusively prove or disprove the above allegation. Therefore, the allegation is considered unsubstantiated and no deficiency is cited. A finding that the complaint is 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.

LPA reviewed this report with Licensee. The licensee was provided a copy of her appeal rights (LIC 9058 01/16) and her signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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