440709560-8-28-2019-07-CC-ASTR-BG4UEM-20190917153122

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 440709560
Report Date: NO Visit Data Available
Date Signed: 08/28/2019 12:55:04 PM

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
and conducted by Evaluator Mahvash Behbood

COMPLAINT CONTROL NUMBER: 07-CC-20190710132937

FACILITY NAME:	PAJARO VALLEY CHILDREN'S CENTER		FACILITY NUMBER:	440709560
ADMINISTRATOR:	ROSA MENDOZA		FACILITY TYPE:	850
ADDRESS:	234 MONTECITO STREET		TELEPHONE:	(831) 722-3737
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	24	CENSUS: 6	DATE:
		UNANNOUNCED	TIME BEGAN:
MET WITH:	Rosa Mendoza		TIME COMPLETED:

ALLEGATION(S):

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Staff speaks inappropriately to children in care.
Staff handled child in a rough manner.

INVESTIGATION FINDINGS:

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A visit was made by Analyst Behbood to further investigate the above allegations. Met staff who informed analyst that Site Supervisor is away from facilty running errands for the faciltiy. Purpose of visit explained. 4 children were interviewed in addition to one staff. Site Supervisor arrived at the end of visit.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash Behbood	TELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:	DATE:

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE:

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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