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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073404172
Report Date: 10/25/2021
Date Signed: 10/25/2021 04:35:17 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
05/24/2021 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20210524112102
FACILITY NAME:VERDUZCO, LISAFACILITY NUMBER:
073404172
ADMINISTRATOR:VERDUZCO, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 234-9988
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:14CENSUS: 6DATE:
10/25/2021
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:LISA VERDUZCOTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS- ADULT IN HOME YELLED AT A DAY CARE CHILD

PERSONAL RIGTTS- FACILITY DOES NOT PROVIDE A SAFE ENVIORNMENT FOR DAY CARE CHILDREN

PERSONAL RIGHTS- LICEENSEE AND ADULT IN HOME'S BEHAVIOR POSES A RISK TO THE CARE OF CHILDREN
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LICENSING PROGRAM ANALYST TASHA ALEXANDER MET WITH LICENSEE LISA VERDUZCO TO DELIVER THE FINDINGS TO THE ABOVE COMPLAINT ALLEGATIONS.

UPON ARRIVAL THERE ARE 6 CHILDREN IN CARE ALONG WITH LICENSEE AND HUSBAND. TODAY INTERVIEWS WERE CONDUCTED WITH CHILDREN IN CARE AND AS WELL AS A BRIEF INSPECTION OF THE HOME.


ALTHOUGH THE ALLEGATIONS MAY HAVE HAPPENED OR IS VALID, THERE IS NOT A PREPONDERANCE OF EVIDENCE TO PROVE THE ALLEGED VIOLATIONS DID OR DID NOT OCCUR, THEREFORE THE ALLEGATIONS ARE UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
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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