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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274405087
Report Date: 11/13/2024
Date Signed: 11/13/2024 01:24:52 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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
09/04/2024 and conducted by Evaluator Fermin Campos-Jaramillo
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240904122405
FACILITY NAME:ORTIZ, MARIA & ROCHA, JOSEFACILITY NUMBER:
274405087
ADMINISTRATOR:ORTIZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 633-8721
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY:14CENSUS: 10DATE:
11/13/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Maria Ortiz and Jose RochaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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9
Child left in car seat.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with the licensees Maria Ortiz and Jose Rocha. LPA explained to license the purpose of today's visit is: Deliver the investigation findings on the above-mentioned allegation. LPA observed that licensees were providing care to 10 children including 4 infants and 6 preschool age children.
This Department has investigated the allegation, based on LPA observations and interviews with the licensees, the reporting party, and some parents of the children attending the home, which were conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Family Childcare Home regulation is being cited on the attached LIC. 9099D.

One Type B deficiency was cited today.

A NOTICE OF SITE VISIT WAS PRINTED AND HANDED TO THE LICENSEE, MUST BE POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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
Control Number 07-CC-20240904122405
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ORTIZ, MARIA & ROCHA, JOSE
FACILITY NUMBER: 274405087
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/27/2024
Section Cited
CCR
102423(a)(2)
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(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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Licensee shall read the children personal rights and submit to Licensing Program a statement declaring that licensee understands the children's rights and the licensee's plans to avoid this violation to repeat in the future. Licensee will submit the statement no later than 11/27/24.
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This requirement was not met as evidenced by: Licensee placed a child who was awake in a car seat while licensee enter to use the bathroom of the house, this poses a potential risk health, safety, personal rights 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.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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
SAN JOSE CC RO, 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
09/04/2024 and conducted by Evaluator Fermin Campos-Jaramillo
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240904122405

FACILITY NAME:ORTIZ, MARIA & ROCHA, JOSEFACILITY NUMBER:
274405087
ADMINISTRATOR:ORTIZ, MARIAFACILITY TYPE:
810
ADDRESS:10880 DAVIS STREETTELEPHONE:
(831) 633-8721
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY:14CENSUS: 10DATE:
11/13/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Maria Ortiz and Jose RochaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider not supervising children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
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9
10
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12
13
Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with Maria Ortiz & Jose Rocha licensees. LPA explained to the licensee the purpose of today's visit is: Deliver the investigation findings on the above-mentioned allegation. LPA observed Licensee was providing care to 10 children including 4 infants and 6 preschool age children. Licensee was working in compliance with ratio and capacity today.
The LPA has interviewed the licensee, and over the phone the reporting party (RP), and the parents of the children attending the FCCH.
Based on the available evidence, it is concluded that although the allegation listed on this complaint may have happened, or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are therefore UNSUBSTANTIATED.

No deficiencies were cited today.

NOTICE OF SITE VISIT WAS PRINTED AND HANDED TO THE LICENSEE, MUST BE POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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