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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434410468
Report Date: 02/23/2022
Date Signed: 02/23/2022 02:50:21 PM

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: 11DATE:
02/23/2022
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Abelicia GaetaTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Criminal Record Clearance - two unfingerprinted adults residing in the home
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Deanna Villagrana met with licensee Abelicia Gaeta to open up and investigation for the above allegations. Present were licensee and nine day care children. Two additional children arrived a short time later. Licensee's husband arrived about 30 minutes later.

Based on LPA's observation and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Licensee rents out the studio in the back of the home to Alicia Garcia and her adult daughter Alicia Garcia who do not have fingerprint clearance. California Code of Regulations, Health and Safety Code 1596.80, are being cited on the attached LIC9099D.

Notice of site visit was issued and must be posted for 30 days.
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: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
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 3
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: 02/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/24/2022
Section Cited
CCR
102370(d)(1)
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This requirement was not met as evidenced by Licensee rents out the studio in the back of the home to Alicia Garcia and her adult daughter Alicia Garcia who do not have fingerprint clearance.
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Licensee will have tenants fingerprinted by 02/24/2022 and ensure they are cleared. Licensee understands all adults living on the premises shall be cleared prior.
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This poses an immediate risk to the Health, Safety or Personal Rights to children in care.
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AB633 Parent Notification is required.
This page shall be provided to all parents of children currently enrolled and any future children being enrolled for the next 12 months per AB633 requirements.
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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: 02/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3