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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274408753
Report Date: 01/09/2024
Date Signed: 01/09/2024 01:22:05 PM

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
12/29/2023 and conducted by Evaluator Elizabeth Larios
COMPLAINT CONTROL NUMBER: 07-CC-20231229082636
FACILITY NAME:KIDS AT PLAYFACILITY NUMBER:
274408753
ADMINISTRATOR:DENISE CARATTINIFACILITY TYPE:
830
ADDRESS:1441 CONSTITUTION BLVD. #151TELEPHONE:
(831) 769-8697
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:16CENSUS: 5DATE:
01/09/2024
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Indya HawthoneTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Infant sustained unexplained injury while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Larios conducted an unannouced inspection to deliver the complaint allegation listed above. LPA met with Teacher, Indya Hawthone and explained the purpose of today's visit.

Based on the available evidence, it is concluded that although the allegation listed on this complaint (Infant sustained unexplained injury while in care) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is therefore UNSUBSTANTIATED.

No deficiency was cited. Exit interview was conducted, where this report was reviewed and discussed with Teacher, Indya Hawthone.

====CONTINUED ON LIC 9099-C====
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
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 07-CC-20231229082636
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KIDS AT PLAY
FACILITY NUMBER: 274408753
VISIT DATE: 01/09/2024
NARRATIVE
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A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2