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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198013810
Report Date: 04/17/2026
Date Signed: 04/20/2026 09:12:00 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 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
02/10/2026 and conducted by Evaluator Alicia Mooberry
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20260210143215
FACILITY NAME:JAUREQUI FAMILY CHILD CAREFACILITY NUMBER:
198013810
ADMINISTRATOR:JAUREQUI, MIRNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 964-3957
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:14CENSUS: 2DATE:
04/17/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Mirna Jaurequi, LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Failure to report to the department
INVESTIGATION FINDINGS:
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On April 17 1:10pm Licensing Program Analyst (LPA) Alicia Mooberry arrived at the faciltiy above and conducted an unannounced complaint inspection to deliver finding for the above allegation. LPA met with licensee Mirna Jaurequi and informed of the purpose of the inspection. LPA observed 2 infants in care at the time of arrival.

An investigation regarding allegation that the licensee did not report and incident involving child #1 that occured on 1/19/26 that required medical attention was completed. Based on documents reviewed, video evidence obtained by LPA and licensee's admission the preponderance of evidence standard has been met, therefore the allegation of failure to report incident is Substatiated.

--Page 1, Report continues
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
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 5
Control Number 54-CC-20260210143215
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810
VISIT DATE: 04/17/2026
NARRATIVE
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On 2/10/26 the department received information that on 01/19/26 child #1 (infant age 7 months) had a medical emergency while in care at the facility, the paramedics were called. Records reviewed did not show that the department received incident report as required by the facility. Per licensee, confirmed she did not report the incident because they were nervous.

During this investigation LPA reviewed facility files, reviewed and obtained video footage of the incident,
conducted interviews with the licensee, staff, and children in care.
Licensee failure to report an incident that required medical attention posed a potential risk to the health and safety of children in care. One B deficiency is cited on this date. California Code of Regulations, Title 22, Division 12 & Section 102416.2(a)(b)(3)(B), is being cited on the attached LIC 9099D.

Exit interview was conducted with Licensee Mirna Jaurequi and a copy of this report was provided. Appeal rights were provided and explained.

A Notice of Site Visit and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 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
02/10/2026 and conducted by Evaluator Alicia Mooberry
COMPLAINT CONTROL NUMBER: 54-CC-20260210143215

FACILITY NAME:JAUREQUI FAMILY CHILD CAREFACILITY NUMBER:
198013810
ADMINISTRATOR:JAUREQUI, MIRNAFACILITY TYPE:
810
ADDRESS:10468 SOMERSET BLVD.TELEPHONE:
(562) 964-3957
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:14CENSUS: 2DATE:
04/17/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Mirna Jaurequi, LicenseeTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Lack of Supervision resulted in a child injury that required medical attention
INVESTIGATION FINDINGS:
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On April 17 1:10pm Licensing Program Analyst (LPA) Alicia Mooberry arrived at the faciltiy above and conducted an unannounced complaint inspection to deliver finding for the above allegations. LPA met with licensee Mirna Jaurequi and informed of the purpose of the inspection. LPA observed 2 infants in care at the time of arrival. Child #1 (infant age 9 months and licensee's grandchild) was picked up by parent at 1:30pm. Also present was Adult #1, assistant.

An investigation regarding the allegation of lack of supervision resulted in injury, based on interviews conducted and video evidence reviewed by LPA, the allegation is unsubstatiated, 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.
On 2/10/26 the department received information that on 01/19/26 child #1 (infant age 7 months) had a medical emergency while in care at the facility, the paramedics were called. --Page 1, Report continues
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 54-CC-20260210143215
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810
VISIT DATE: 04/17/2026
NARRATIVE
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During this investigation LPA reviewed facility files, reviewed and obtained video footage of the incident,
conducted interviews with the licensee, staff, and children in care.

Interviews conducted reported that C1 was supervised by licensee and Adult #1, Assistant, when C1 had medical emergency requiring CPR. LPA reviewed video footage that was provided by licensee and observed that both licensee and Adult #1 were in the same room when C1 had medial emergency. A parent volunteer, Adult #1 and Licensee are observed providing care to C1, calling parent and paramedics. Based on the evidence obtained and reviewed there was no evidence that C1's personal rights were violated.

Exit interview was conducted with Licensee Mirna Jaurequi and a copy of this report was provided. Appeal rights were provided and explained.



A Notice of Site Visit and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 54-CC-20260210143215
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JAUREQUI FAMILY CHILD CARE
FACILITY NUMBER: 198013810
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2026
Section Cited
CCR
102416.2(a)(b)(3)(B)
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The licensee shall report to the Department... next business day and during normal working hours…following the occurrence during the operation of a family day care home of...Any injury to any child that requires medical treatment. -This requirement is not met as evidenced by:
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The licensee has completed the LIC 624B reporting the incident that occured on 1/19/26. Per licensee, they will provide a written statement on how that will follow the reporting requirements and sent the department by 4/21/26
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Based on documents reviewed, video evidence obtained by LPA and licensee's admission the licensee did not report and that C1 had a medical emergency that required medical assistance posing a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Warren Birks
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5