434411571-9-11-2023-07-CC-JSEA-CXJVUY-20231113154531

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434411571
Report Date: 09/11/2023
Date Signed: 09/11/2023 03:14:54 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
08/15/2023 and conducted by Evaluator Deanna Villagrana

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230815165720

FACILITY NAME:	GONZALEZ, HILDA		FACILITY NUMBER:	434411571
ADMINISTRATOR:	GONZALEZ, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 843-3452
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	14	CENSUS: 7	DATE:	09/11/2023
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Hilda Gonzalez		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Licensee spoke inappropriately to day care child

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Deanna Villagrana met with licensee Hilda Gonzalez to deliver findings for above allegation. LPA explained the nature of the visit. Present were licensee, licensee's granddaughter Leslie Zepeda who is her assistant and seven day care children including three infants.

Based on interviews, which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, (Title 22, Division 12, Chapter 1) 102370(d)(1). Licensee spoke to a child inappropriately by telling child she was going to call the police on child if they did not behave.
The following type B deficiency was cited on the attached page (809-D). Licensee was informed that failure to correct the deficiencies by the specified Plan of Correction (POC) Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

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 Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

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-20230815165720

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: GONZALEZ, HILDA	FACILITY NUMBER: 434411571
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/12/2023 Section Cited CCR 102423(a)(3)	1 2 3 4 5 6 7	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.	1 2 3 4 5 6 7	Licensee will submit a statement stating she will not talk to children inappropriately to CCLD by POC date.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by Licensee spoke to a child inappropriately by telling child she was going to call the police on child if they did not behave. This poses a potential risk Health, Safety Personal Rights risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna Villagrana	TELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2023

LIC9099 (FAS) - (06/04)

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