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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434410468
Report Date: 04/28/2022
Date Signed: 04/28/2022 11:50:58 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
02/15/2022 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220215105615
FACILITY NAME:GAETA, ABELICIAFACILITY NUMBER:
434410468
ADMINISTRATOR:GAETA, ABELICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 842-8076
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:14CENSUS: 9DATE:
04/28/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Abelicia GaetaTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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9
Personal Rights - inappropriate discipline
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Deanna Villagrana met with licensee Abelicia Gaeta to deliver findings for the above allegation. LPA explained the nature of the visit. Present were licensee, licensee's husband, licensee's son Gilberto Gaeta and nine day care children including two infants.

Based on LPA's interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Child was inappropriately disciplined after going to the bathroom in their underwear. California Code of Regulations, Health and Safety Code 1596.80, are being cited on the attached LIC9099D.

LPA Deanna Villagrana informed licensee Abelicia Gaeta that this report dated 04/28/2022 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) 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: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
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 4
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
02/15/2022 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220215105615

FACILITY NAME:GAETA, ABELICIAFACILITY NUMBER:
434410468
ADMINISTRATOR:GAETA, ABELICIAFACILITY TYPE:
810
ADDRESS:701 WELBURN AVENUETELEPHONE:
(408) 842-8076
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:14CENSUS: 9DATE:
04/28/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Abelicia GaetaTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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2
3
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5
6
7
8
9
Personal Rights - exposed children to covid
Reporting Requirements - failed to report positive covid
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Deanna Villagrana met with licensee Abelicia Gaeta to deliver findings for the above allegation. LPA explained the nature of the visit. Present were licensee, licensee's husband, licensee's son Gilberto Gaeta and nine day care children including two infants.

Based on interviews, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiency was cited.

Notice of Site was issued and must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 07-CC-20220215105615
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: GAETA, ABELICIA
FACILITY NUMBER: 434410468
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/28/2022
Section Cited
CCR
102423(a)(2)
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Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment. This requirement was not met as evidenced by Child was inappropriately disciplined after going to the bathroom in their underwear.
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Licensee understands children must be treated with dignity and respect and will not wash children under cold water after going to the bathroom in their pants.
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This poses an immediate risk to the Health, Safety or Personal Rights 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: 04/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20220215105615
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: GAETA, ABELICIA
FACILITY NUMBER: 434410468
VISIT DATE: 04/28/2022
NARRATIVE
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Also, LPA Deanna Villagrana informed the licensee Abelicia Gaeta to provide a copy of this licensing report dated 04/28/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4