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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444412917
Report Date: 01/20/2023
Date Signed: 01/24/2023 10:07:35 AM

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
01/17/2023 and conducted by Evaluator Elizabeth Berumen
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230117135420
FACILITY NAME:ROCHA, ESPERANZAFACILITY NUMBER:
444412917
ADMINISTRATOR:ROCHA, ESPERANZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-2758
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 5DATE:
01/20/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Esperanza RochaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Child wandered away from the family child care home
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Elizabeth Berumen, conducted an unannounced complaint visit to the home today. LPA met with Licensee, Esperanza Rocha and explained the nature of today's visit to her. LPA also observed five day care children (1 infant and 4 preschool age) and Licensee's assistant, Joel Fernandez present in the home during today's visit.

An incident occurred on January 17, 2023 in which a 4 year old day care child wandered away and was found by a passerby walking south bound on Western Drive attempting to cross Main Street. Esperanza Rocha states that the child wandered away during nap time; while she was cleaning. Mrs. Rocha states that she realized child was missing when Officer Gonzalez knocked on her door.

Based on information gathered the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1), is being cited on the attached LIC. 9099D. "Type A" deficiency is noted on the attached page (9099-D):
A notice of site visit was issued and posted near the facility entrance along with the Type "A" citation and both notices must remain posted for 30 consecutive days. The Licensee must provide copies of this report to parents/guardians of children in care at this facility and to parents/guardians of children newly enrolled at this facility during the next 12 months.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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 2
Control Number 07-CC-20230117135420
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: ROCHA, ESPERANZA
FACILITY NUMBER: 444412917
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/20/2023
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home.
The licensee shall be present in the home and shall ensure that children in care are supervised at all times.
This requirement was not me as evidenced by:
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Licensee needs to implement a written Plan of Correction (POC) indicating what steps she is taking to ensure that the day care children are supervised at all times to thus prevent any child(ren) from wandering away from the Family Child Care Home.
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On January 17, 2023, A 4 year old day-care child wandered away from the family child care home and was found by a passerby.
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The Licensee will also be required to attend an informal meeting at the San Jose Regional Office within the next 2-3 weeks. A letter confirming the date & time of the conference will be sent to the Licensee via mail.

This is an immediate health and saftey violation (zero tolerence) a civil penatly of $500.00 is being accessed today.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2