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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434403765
Report Date: 10/19/2022
Date Signed: 10/25/2022 10:23:17 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
08/03/2022 and conducted by Evaluator Elizabeth Berumen
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220803093115
FACILITY NAME:TERRAZAS, MARIAFACILITY NUMBER:
434403765
ADMINISTRATOR:TERRAZAS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 972-8173
CITY:SAN JOSESTATE: CAZIP CODE:
95111
CAPACITY:14CENSUS: 10DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Maria TerrazasTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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staff use inappropriate forms of discipline with day care children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Maria Terrazas to deliver findings for the above allegation. LPA explained the nature of the inspection to Licensee. Present were licensee, Licensee's two assistants (Valeria Loza and Maria Gomez), and 10 day care children.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC. 9099D.


LPA Elizabeth Berumen informed Licensee, Maria Terrazas that this report dated 10/19/2022 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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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Control Number 07-CC-20220803093115
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: TERRAZAS, MARIA
FACILITY NUMBER: 434403765
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/27/2022
Section Cited
CCR
102423(a)(4)
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102423(a)(4) Personal Rights.
To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
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Licensee agress to have a meeting with her staff and discuss positive discipline methods. All staff are to understand that children's personal rights should not be violated.
A copy of meeting agenda with signatures will be sent to San Jose Regional Office.
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This requirement was not me as evidenced by:
Based on interviews conducted LPA learned that a staff member tilted a child size high chair while child was sitting in the chair; child was asked to pick up items that child threw on the floor.

This violation poses an immediate Health and Safety risk to children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

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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: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
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