270767399-7-16-2019-07-CC-SKNT-BEL2JU-20190730172654

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 270767399
Report Date: 07/16/2019
Date Signed: 07/16/2019 09:28:31 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2019 and conducted by Evaluator Joseph Macias

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20190429132132

FACILITY NAME:	MERILOS, SMYRNA		FACILITY NUMBER:	270767399
ADMINISTRATOR:	MERILOS, SMYRNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 449-7958
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	14	CENSUS: 8	DATE:	07/16/2019
		UNANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Smyrna Merilos		TIME COMPLETED:	09:25 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee failed to provide adequate supervision.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Joe Macias, conducted an unannounced inspection in order to deliver findings on the complaint investigation of above allegation. LPA Macias met with the Licensee Smyrna Merilos, to discuss complaint allegation findings.

LPA Macias interviewed Licensee, Complainant, and children, toured the home, and obtained copies of pertinent information. Throughout the investigation process, it was found the allegation (Licensee failed to provide adequate supervision) is UNSUBSTANTIATED. Based on information obtained; there is not enough evidence to prove that the above allegation occurred. A finding that is unsubstantiated means although the allegation may have happened or is valid , the preponderance of evidence does not prove it.

Exit interview conducted and copy of this report provided to the Licensee.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

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