274413138-5-27-2020-07-CC-MSEA-BPZU6X-20200527151901

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 274413138
Report Date: 05/27/2020
Date Signed: 05/27/2020 02:11:20 PM

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
02/28/2020 and conducted by Evaluator Fermin Campos-Jaramillo

COMPLAINT CONTROL NUMBER: 07-CC-20200228093959

FACILITY NAME:	MAOF TANIMURA AND ANTLE EARLY LEARNING CENTER		FACILITY NUMBER:	274413138
ADMINISTRATOR:	MENDEZ, ANGIE		FACILITY TYPE:	830
ADDRESS:	121 SPRECKLES BLVD		TELEPHONE:	(831) 455-9947
CITY:	SPRECKLES	STATE: CA	ZIP CODE:	93962
CAPACITY:	18	CENSUS: 0	DATE:	05/27/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Luisa Becerra		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff left day care children unattended
Facility out of ratio

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met via FaceTime, with Maria Luisa Becerra, Site Director, to deliver findings on the above named allegations. LPA observed the Center is closed for children. Director stated there are not children present and 4 staff members present today just doing paper work and cleaning.
This Department has reviewed documents provided by the center, interviewed some children's parents, and interviewed staff members. Although the allegations noted above on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The Department’s findings are that this allegations are UNSUBSTANTIATED.

No deficiencies are cited today.
A NOTICE OF SITE VISIT WAS ISSUED AND EMAILED AND MUST BE POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
This report has been email to the Site Director who will reply to the email in lieu of a signature

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2020

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 1