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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 350706551
Report Date: 07/21/2022
Date Signed: 07/22/2022 08:34:13 AM

Substantiated


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
07/19/2022 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220719143014
FACILITY NAME:FAUGHT, RENEE & RICHARDFACILITY NUMBER:
350706551
ADMINISTRATOR:FAUGHT, RENEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 801-3721
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:12CENSUS: 4DATE:
07/21/2022
UNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Renee FaughtTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Day Care children are using a porta potty
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Deanna Villagrana met with licensee for a required one year visit. LPA explained the nature of today’s inspection to her. Present was licensee Renee and four day care children.

Based on LPA's observation and interview which was conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED, Daycare children were using a porta potty. California Code of Regulations, Health and Safety Code 1596.80, are being cited on the attached LIC9099D.

The following type B deficienciy was cited on the attached page (809-D).
A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
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-20220719143014
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: FAUGHT, RENEE & RICHARD
FACILITY NUMBER: 350706551
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2022
Section Cited
CCR
102423(a)(2)
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Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment. This requirement was not met as evidenced by Daycare children were using a porta potty.
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Licensee had company pick up porta potty during visit. Porta potty was removed and deficiency was cleared today.
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This poses a potential risk Health, Safety Personal Rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2