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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444410956
Report Date: 08/13/2021
Date Signed: 08/25/2021 10:34:36 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
06/04/2021 and conducted by Evaluator Elizabeth Berumen
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20210604150251
FACILITY NAME:PALMERIN, ESTELAFACILITY NUMBER:
444410956
ADMINISTRATOR:ESTELA PALMERINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-8094
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 11DATE:
08/13/2021
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Esthela PalmerinTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee hits day care children
Licensee is rough with day care children
Licensee yells at day care children
Licensee threatens day care children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Estela Palmerin to deliver investigation findings. LPA Berumen conducted interviews.

Based on the available evidence, it is concluded that although the allegations listed on this complaint (Licensee hits day care children. Licensee is rough with day care children.
Licensee yells at day care children. Licensee threatens day care children) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is therefore UNSUBSTANTIATED.

NOTICE OF SITE VISIT WAS PROVIDED AND SHALL BE POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
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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