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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622314
Report Date: 09/23/2022
Date Signed: 09/23/2022 01:41:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/04/2022 and conducted by Evaluator Lea Habtom
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220804132512
FACILITY NAME:EAGAN, KACYFACILITY NUMBER:
313622314
ADMINISTRATOR:EAGAN, KACYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 401-6212
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:14CENSUS: 5DATE:
09/23/2022
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Kacy EaganTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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9
Facility does not provide a safe and healthful environment for day care children.
INVESTIGATION FINDINGS:
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13
On September 23, 2022 Licensing Program Analysts (LPAs) Lea Habtom and Katrina Owens met with licensee Kacy Eagan to deliver the findings for the allegation stated above. There was a census of 1 infant and 4 preschool children being supervised by licensee and her assistant.

Facility does not provide a safe and healthful environment for day care children.

During the investigation, LPA Habtom toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that a personal rights violation occurred in that the licensee does not provide a safe and healthful environment for day care children. Based on the limited information gathered, LPA L. Habtom was unable to determine if the licensee allowed her children to attend daycare when they were sick therefore the allegation is found to be UNSUBSTANTAITED. Although it may or may have not happened, there is not a preponderance of evidence to prove that the alleged violations occurred.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
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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