274414483-4-20-2020-07-CC-MSEA-BNXSL2-20200423135736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 274414483
Report Date: 04/20/2020
Date Signed: 04/20/2020 04:58:34 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
03/03/2020 and conducted by Evaluator Susy Cervantes

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20200303124326

FACILITY NAME:	ARIZMENDI, CONNIE M		FACILITY NUMBER:	274414483
ADMINISTRATOR:	ARIZMENDI, CONNIE M		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 313-7019
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	14	CENSUS: 0	DATE:	04/20/2020
		UNANNOUNCED	TIME BEGAN:	04:25 PM
MET WITH:	Connie Arizmendi		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Child's diaper was not properly changed while in care.

INVESTIGATION FINDINGS:

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On 4/20/2020 at 4:25 PM, Licensing Program Analyst, Susy Cervantes, contacted licensee Connie Arizmendi for a "tele-visit" inspection investigation and explained the reason for the visit. Tele-visit was conducted due to Covid-19. Purpose of today's inspection: deliver investigation findings.

LPA conducted interviews to licensee, parents and R&R staff. Based on interviews conducted, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Licensee in Spanish. LPA informed Licensee that her report, appeal rights, and notice of site visit will be emailed to her. Licensee understands that in lieu of a signature, a read receipt or confirmation of receiving the report email must be submitted within 24 hours.
No deficiencies were cited during today's inspection. Notice of site visit must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2020

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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