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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434412542
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:38:40 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
04/26/2023 and conducted by Evaluator Kassandra Medrano
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230426145906
FACILITY NAME:MENDOZA-MADRIGAL, CARMEN & RAFAELFACILITY NUMBER:
434412542
ADMINISTRATOR:CARMEN & RAFAELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 793-4520
CITY:LOS GATOSSTATE: CAZIP CODE:
95033
CAPACITY:14CENSUS: 1DATE:
06/29/2023
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Carmen & RafaelTIME COMPLETED:
03:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not allow parents entry into facility.
Licensee did not meet childrens diapering needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kassandra Medrano conducted an unannounced subsequent site visit to the facility to deliver investigation findings. LPA met with Licensees, carmen and rafael purpose of the inspection was explained. LPA Medrano toured the facility and inspected the home for health and safety hazards. Present in the home were the two licensees, one child, and her 3 minor children.

LPA Medrano conducted interviews, toured the facility and obtained copies of pertinent information. Throughout the investigation process, it was found the allegations listed above were unsubstantiated. Based on information obtained; there is not enough evidence to prove that the above allegations could have occurred. Due to the above information, the allegations are UNSUBSTANTIATED. A finding that is unsubstantiated means although the allegation may have happened or is valid, the preponderance of evidence does not prove it.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
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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