306005844-2-23-2024-22-AS-AORZ-D2VR26-20240228113750

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005844
Report Date: 02/23/2024
Date Signed: 02/23/2024 10:16:00 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/03/2024 and conducted by Evaluator Andrea Mendivil

COMPLAINT CONTROL NUMBER: 22-AS-20240103150616

FACILITY NAME:	BLUE SKIES OF LAGUNA NIGUEL		FACILITY NUMBER:	306005844
ADMINISTRATOR:	RUTH KHAY		FACILITY TYPE:	740
ADDRESS:	25437 VIA ESTUDIO		TELEPHONE:	(949) 503-3553
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	6	CENSUS: 4	DATE:	02/23/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Laurence Laurence - Caregiver		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Licensee abandoned facility

INVESTIGATION FINDINGS:

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On this Day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility by Caregiver Laurence Laurence and explained the reason for the visit. Administrator Chet Khay was available by phone.

The Department received a complaint on 01/03/2024 and LPA Mendivil conducted the initial visit on 01/11/2024. LPA Mendivil interviewed staff and current Licensee. LPA Mendivil obtained copies of rental agreements, management agreements, and liability insurance. Regarding the allegation Licensee abandoned the facility, the investigation revealed the following:

It was alleged that the current Licensee Hanh Dao has abandoned the facility. Based on interviews with Hanh Dao, the facility is currently operated by Administrators Ruth Khay and Chet Khay as they are in the process of applying for their own license.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-4084
LICENSING EVALUATOR NAME: Andrea Mendivil	TELEPHONE: 714-703-2738
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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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Control Number 22-AS-20240103150616

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BLUE SKIES OF LAGUNA NIGUEL	FACILITY NUMBER: 306005844
	VISIT DATE: 02/23/2024

NARRATIVE

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Per review Licensee Hanh Dao is still currently licensee until Chet Khay and Ruth Khay have their application approved. Current Licensee Hanh stated she is in contact with the perspective Licensee monthly and is updated on issues with the facility. Administrator Chet Khay stated he is in the process of submitting an application to the Department for Change of Ownership as of 2/23/2024.

Therefore, based on a preponderance of evidence through interviews and records reviewed the allegation that licensee abandoned facility is determined to be UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. This agency has investigated this complaint.
No deficiencies cited.

An exit interview was conducted and a copy of this report was provided to facility staff.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-4084
LICENSING EVALUATOR NAME: Andrea Mendivil	TELEPHONE: 714-703-2738
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC9099 (FAS) - (06/04)

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