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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274410788
Report Date: 10/22/2021
Date Signed: 10/24/2021 08:22:58 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, 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
07/29/2021 and conducted by Evaluator Elizabeth Larios
COMPLAINT CONTROL NUMBER: 07-CC-20210729121808
FACILITY NAME:M.A.O.F. MOUNTAIN VALLEY EARLY LEARNING CENTERFACILITY NUMBER:
274410788
ADMINISTRATOR:VICKY SANTOSFACILITY TYPE:
850
ADDRESS:115 BARDIN ROADTELEPHONE:
(831) 771-9291
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY:120CENSUS: 23DATE:
10/22/2021
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Jazmin CamachoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff did not obtain medical treatment for daycare child in a timely manner
Staff did not notify authorized representative of an incident in a timely manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Larios conducted an unannouced inspection to deliver the complaint allegation listed above. LPA met with Assistant, Jazmin Camacho and explained the purpose of the inspection.

Based on the available evidence, it is concluded that although the allegations listed on this complaint (Staff did not obtain medical treatment for daycare child in a timely manner, and Staff did not notify authorized representative of an incident in a timely manner) 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.

No deficiency was cited. Exit interview was conducted, where this report was reviewed and discussed with Anna Contreras, Site Supervisor, and Jazmin Camacho, Assistant.

CONTINUED ON LIC 9099-D.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021
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-20210729121808
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: M.A.O.F. MOUNTAIN VALLEY EARLY LEARNING CENTER
FACILITY NUMBER: 274410788
VISIT DATE: 10/22/2021
NARRATIVE
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A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2