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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409509
Report Date: 08/04/2026
Date Signed: 08/04/2026 01:11:27 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
07/27/2026 and conducted by Evaluator Tasha Hackett-Alexander
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20260727165221
FACILITY NAME:NGUYEN, NHAFACILITY NUMBER:
073409509
ADMINISTRATOR:NGUYEN, NHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 813-4015
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:14CENSUS: 9DATE:
08/04/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:NHA NGUYENTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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OTHER- Provider does not respond to pool alarm device/absent from pool
INVESTIGATION FINDINGS:
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On August 4, 2026 Licensing Program Analysts (LPAs) Tasha Alexander and Nicole Reynos conducted a 10 day initial inspection at the licensee's family child care home. LPAs met with licensee Nha Nguyen and explained the purpose of the visit.

Upon entry of the home, LPAs observed three (3) adults along with nine (9) children, consisting of 2 infants and 7 preschoolers. LPAs toured the backyard and swimming pool area for a health and safety inspetion. The complainant statement alleges that the provider does not respond to the pool alarm device. On 7/23/26 the alarm sounded off for several minutes and then appeared to be removed. Per licensee, Her child and a friend were in the pool and did not know how to shut it off so they removed it. During the tour of the swimming pool area today, LPAs did not observe the swimming pool alarm inside of the swimming pool. Per licensee, this was due to her "bot" being in the pool for cleaning. According to Health & Safety Code, the alarm must be inside of the pool during day care hours. The swimming pool remains fully fenced.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 & Chapter 03.4, are being cited on the attached LIC. 9099D.

An exit interview was conducted with licensee Nha Ngyuen
A notice of site visit was given and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
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 02-CC-20260727165221
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: NGUYEN, NHA
FACILITY NUMBER: 073409509
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/05/2026
Section Cited
HSC
1596.814a1(b)(ii)(l)
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1596.814 Family daycare home; in-ground swimming pool requirements
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:
(B) In addition to the characteristics described in subparagraph (A), at least one of the following
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The alarm was put inside of the swimming pool during today's inspection. Licensee will ensure that the swimming pool alarm remains inside of the swimming pool during hours of operation. Failure to comply will result in a Type A violation and possible civil penalty.
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(ii) (I) An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use. This requirement is not met as evidenced by observations which revealed the pool alarm is not in the swimming pool today. this poses a potential health & safety risk to children in care
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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.
SUPERVISOR'S NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2