270767633-4-7-2022-07-CC-JSEA-CDV2DJ-20220426171821

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 270767633
Report Date: 04/07/2022
Date Signed: 04/07/2022 09:32:33 AM

Unsubstantiated

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
01/27/2022 and conducted by Evaluator Joseph Macias

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220127091135

FACILITY NAME:	NEWELL, SYLVIA		FACILITY NUMBER:	270767633
ADMINISTRATOR:	NEWELL, SYLVIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 384-4003
CITY:	MARINA	STATE: CA	ZIP CODE:	93933
CAPACITY:	14	CENSUS: 1	DATE:	04/07/2022
		UNANNOUNCED	TIME BEGAN:	08:13 AM
MET WITH:	Sylvia Newell		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Conduct of an adult in the home poses a risk to children in care.
Licensee is not following protocols to prevent the spread of illness.

INVESTIGATION FINDINGS:

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

LPA Macias interviewed staff, parents, and other parties involved, observed the home, as well as obtained copies of pertinent information. Throughout the investigation process, it was found the allegations (conduct of an adult in the home poses a risk to children in care, and Licensee is not following protocols to prevent the spread of illness) are UNSUBSTANTIATED; based on interviews, and information gathered by LPA Macias. 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 was left with the Licensee Sylvia Newell.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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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