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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 394500999
Report Date: 07/09/2026
Date Signed: 07/09/2026 10:42:23 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/15/2026 and conducted by Evaluator Deborah Khashe
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20260415090750
FACILITY NAME:DOUGLASS, KATHERYNE & GOMEZ, KARENFACILITY NUMBER:
394500999
ADMINISTRATOR:DOUGLASS, KATHERYNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 513-0576
CITY:STOCKTONSTATE: CAZIP CODE:
95215
CAPACITY:14CENSUS: 0DATE:
07/09/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Katheryne DouglassTIME COMPLETED:
11:05 AM
ALLEGATION(S):
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Licensee transport daycare children in an unsafe manner.
Licensee uses inappropriate forms of discipline.
Daycare is unkept.
Child sustained injury due to neglect or physical injury.
INVESTIGATION FINDINGS:
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On July 9, 2026, Licensing Program Analyst met with Licensee Katheryne Douglass to deliver the findings of a complaint investigation. During today’s visit, only the licensee’s children were present. Katheryne Douglass states she does not have any children enrolled in her Family Child Care Home due to her resent move to a new residence.

It was alleged that Licensee transport children in an unsafe manner, Licensee uses inappropriate forms of discipline, daycare is unkempt, and child sustained injury due to licensee’s neglect or abuse.
During the investigation, LPA Khashe gathered pertinent documentation, conducted file review, conducted child and parent interviews. LPA Khashe conducted unannounced visits where LPA Khashe observed that Licensee, Katheryne Douglass did have all children in car seats while transporting day care children in her vehicle.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
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 2
Control Number 53-CC-20260415090750
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: DOUGLASS, KATHERYNE & GOMEZ, KAREN
FACILITY NUMBER: 394500999
VISIT DATE: 07/09/2026
NARRATIVE
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Based on the information obtained throughout the course of this investigation the above allegations could not be substantiated or dismissed. 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, therefore the findings are UNSUBSTAINTIATED.

An Exit Interview was conducted in which the report was reviewed and discussed with licensee, Katheryne Douglass. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2