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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409194
Report Date: 11/15/2023
Date Signed: 11/15/2023 10:09:20 AM

Unsubstantiated


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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/22/2023 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20230822100325
FACILITY NAME:ROMO, CRISTINAFACILITY NUMBER:
073409194
ADMINISTRATOR:ROMO, CRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 375-4269
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 9DATE:
11/15/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:ROMO, CRISTINATIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
RATIO ~ Over capacity.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 15, 2023 at 09:15 AM Licensing Program Analyst (LPA) Nyeesha Blount, conducted an Unannounced Complaint site inspection to deliver complaint findings. LPA met with Licensee Romo, Cristina also present was (1) staff members who are background cleared. LPA advised Licensee of the nature of the inspection. Current Census today is 9 children which consists of (2) infants, (7) preschoolers. LPA obtained a copy of the children's roster, observations and staff interviews were conducted.

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. Exit interview conducted. Appeal rights were discussed and given. This report must be kept available for public review for (3) years. Notice of site visit given.
Unsubstantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/22/2023 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20230822100325

FACILITY NAME:ROMO, CRISTINAFACILITY NUMBER:
073409194
ADMINISTRATOR:ROMO, CRISTINAFACILITY TYPE:
810
ADDRESS:178 PEARCETELEPHONE:
(510) 375-4269
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 9DATE:
11/15/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:ROMO, CRISTINATIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights ~ The facility does not have comfortable temperature, Not following the safe sleep guidelines,Provider using off limit area.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 15, 2023 at 09:15 AM Licensing Program Analyst (LPA) Nyeesha Blount, conducted an Unannounced Complaint site inspection to deliver complaint findings. LPA met with Licensee Romo, Cristina also present was (1) staff members who are background cleared. LPA advised Licensee of the nature of the inspection. Current Census today is 9 children which consists of (2) infants, (7) preschoolers. LPA obtained a copy of the children's roster, observations and staff interviews were conducted.

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. Exit interview conducted. Appeal rights were discussed and given. This report must be kept available for public review for (3) years. Notice of site visit given.
Unsubstantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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
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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/22/2023 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20230822100325

FACILITY NAME:ROMO, CRISTINAFACILITY NUMBER:
073409194
ADMINISTRATOR:ROMO, CRISTINAFACILITY TYPE:
810
ADDRESS:178 PEARCETELEPHONE:
(510) 375-4269
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 9DATE:
11/15/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:ROMO, CRISTINATIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Physical Plant ~ Backyard has dangerous items accessible to the children in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 15, 2023 at 09:15 AM Licensing Program Analyst (LPA) Nyeesha Blount, conducted an Unannounced Complaint site inspection to deliver complaint findings. LPA met with Licensee Romo, Cristina also present was (1) staff members who are background cleared. LPA advised Licensee of the nature of the inspection. Current Census today is 9 children which consists of (2) infants, (7) preschoolers. LPA obtained a copy of the children's roster, observations and staff interviews were conducted.

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. Exit interview conducted. Appeal rights were discussed and given. This report must be kept available for public review for (3) years. Notice of site visit given.
Unsubstantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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