434414668-2-26-2020-52-CC-AEVS-BMC3WR-20200302173710

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414668
Report Date: 02/26/2020
Date Signed: 02/26/2020 12:45:44 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/06/2019 and conducted by Evaluator Dayna Collier

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20191206110614

FACILITY NAME:	HERNANDEZ, MARIA DEL PILAR		FACILITY NUMBER:	434414668
ADMINISTRATOR:	HERNANDEZ, MARIA DEL PILAR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 704-6266
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	14	CENSUS: 7	DATE:	02/26/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Del Pilar Hernandez		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

OTHER: The conduct of an adult living in the home poses a threat to the health and safety of the children in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Dayna Collier met with licensee Maria del Pilar Hernandez for a complaint investigation regarding the above allegation. Present for the investigation were licensee, licensee's two adult daughters, licensee's daugther's fiance, licensee's assistant Blanca and 7 children in care consisting of 4 infants and 3 preschoolers. Based on an investigation conducted by SI Cari Farquhar of the Bureau of Investigations and due to the lack of evidence, it cannot be proven or disproven that the conduct of an adult living in the home posed a threat to children in care.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is unsubstantiated.

A SITE VISIT NOTICE WAS POSTED BY LICENSEE.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna Collier	TELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/06/2019 and conducted by Evaluator Dayna Collier

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20191206110614

FACILITY NAME:	HERNANDEZ, MARIA DEL PILAR		FACILITY NUMBER:	434414668
ADMINISTRATOR:	HERNANDEZ, MARIA DEL PILAR		FACILITY TYPE:	810
ADDRESS:	3181 BRYANT STREET		TELEPHONE:	(650) 704-6266
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	14	CENSUS: 7	DATE:	02/26/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Del Pilar Hernandez		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

LICENSE: Uncleared adult residing in the home.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Dayna Collier met with licensee Maria del Pilar Hernandez for a complaint investigation regarding the above allegation. Present for the investigation were licensee, licensee's two adult daughters, licensee's daugther's fiance, licensee's assistant Blanca and 6 children in care consisting of 4 infants and 3 preschoolers. It was alleged that licensee's husband resides in or has a presence in the home without having a criminal record clearance. Per licensee, her husband has not lived in the facility nor has had a presence since October 2019. During the investigation, interviews were conducted and disclosed that licensee's husband has been observed at the facility. However, the actual dates of licensee's husband's presence are varying. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is unsubstantiated.

A SITE VISIT NOTICE WAS POSTED BY LICENSEE.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna Collier	TELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/06/2019 and conducted by Evaluator Dayna Collier

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20191206110614

FACILITY NAME:	HERNANDEZ, MARIA DEL PILAR		FACILITY NUMBER:	434414668
ADMINISTRATOR:	HERNANDEZ, MARIA DEL PILAR		FACILITY TYPE:	810
ADDRESS:	3181 BRYANT STREET		TELEPHONE:	(650) 704-6266
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	14	CENSUS: 7	DATE:	02/26/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Del Pilar Hernandez		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

LACK OF SUPERVISION: Uncleared adult providing care and supervision to children.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Dayna Collier met with licensee Maria del Pilar Hernandez for a complaint investigation regarding the above allegation. Present for the investigation were licensee, licensee's two adult daughters, licensee's daugther's fiance, licensee's assistant Blanca and 6 children in care consisting of 4 infants and 7 preschoolers. It was alleged that licensee's husband has provided care and supervision to children without having a criminal record clearance. Per licensee, her husband has not lived in the facility nor has had a presence since October 2019. During the investigation, interviews were conducted and disclosed that licensee's husband has been observed at the facility. However, the actual dates of licensee's husband's presence are varying. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is unsubstantiated.

A SITE VISIT NOTICE WAS POSTED BY LICENSEE.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2590
LICENSING EVALUATOR NAME: Dayna Collier	TELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3