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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073404172
Report Date: 12/30/2020
Date Signed: 12/30/2020 01:54:45 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/08/2020 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20200408092648
FACILITY NAME:VERDUZCO, LISAFACILITY NUMBER:
073404172
ADMINISTRATOR:VERDUZCO, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 234-9988
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:14CENSUS: DATE:
12/30/2020
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:LISA VERDUZCOTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS- Licensees use inappropriate discipline towards children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LICENSING PROGRAM ANALYST ALEXANDER MET WITH LICENSEE LISA VERDUZCO VIA TELE-VISIT DUE TO THE COVID-19 PANDEMIC TO DELIVER THE FINDINGS TO THE ABOVE COMPLAINT ALLEGATION.

ON THIS ANALYST'S LAST VISIT AN INTERVIEW WAS CONDUCTED WITH LICENSEE AND A COPY OF THE FACILITY ROSTER WAS REQUESTED.

ALTHOUGH THE ALLEGATION MAY HAVE HAPPENED OR IS VALID, THERE IS NOT A PREPONDERANCE OF EVIDENCE OF EVIDENCE OF EVIDENCE TO PROVE THE ALLEGED VIOLATION DID OR DID NOT OCCUR, THEREFORE THE ALLEGATION IS UNSUBSTANTIATED.

AN EXIT INTERVIEW WAS CONDUCTED. A COPY OF THIS REPORT IS TO KEPT FOR 3 YEARS. A COPY OF THIS REPORT HAS ALSO BEEN EMAILED TO THE LICENSEE.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2020
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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