274414334-6-25-2021-07-CC-DSTN-C4JVZJ-20210702165249

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 274414334
Report Date: 06/25/2021
Date Signed: 06/25/2021 11:17:56 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
04/26/2021 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20210426093630

FACILITY NAME:	ACADEMY FOR CHILDREN		FACILITY NUMBER:	274414334
ADMINISTRATOR:	DESTINA R. GREEN		FACILITY TYPE:	830
ADDRESS:	1664 HILBY AVENUE		TELEPHONE:	(831) 899-9000
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY:	30	CENSUS: 7	DATE:	06/25/2021
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Amanda Araiza		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Licensee/adult(s) residing at the center in violation of the facility fire clearance

Licensee operating in violation of the lease agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mel Matos conducted an unannounced follow up complaint investigation and met with Amanda Araiza, director. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the two complaint allegations listed in this complaint was conducted by LPA Mel Matos. Based on the available evidence, including observations of the Facility, and interviews completed for the complaint investigation, it is concluded that although the allegations noted 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 allegations are thus UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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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