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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274416060
Report Date: 06/08/2026
Date Signed: 06/08/2026 02:23:38 PM

Unsubstantiated


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
06/04/2026 and conducted by Evaluator Mandeep Kaur
COMPLAINT CONTROL NUMBER: 07-CC-20260604122137
FACILITY NAME:LOPEZ, JAQUELINEFACILITY NUMBER:
274416060
ADMINISTRATOR:JAQUELINE LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 776-2492
CITY:KING CITYSTATE: CAZIP CODE:
93930
CAPACITY:14CENSUS: 8DATE:
06/08/2026
UNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Jaqueline LopezTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Licensee does not ensure the daycare home is clean and sanitary.
Licensee does not provide adequate supervision to children in care.
Licensee does not prevent daycare children from exposure to animal feces.
INVESTIGATION FINDINGS:
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On 06/08/2026, Licensing Program Analyst(LPA) Mandeep Kaur conducted an unannounced complaint investigation. LPA met with Licensee, Jaqueline Lopez and explained the reason of the today's investigation. Upon arrival, present were Licensee's assistant(S1) and 8 children(3 infants and 5 preschool age). LPA toured the indoor and outdoor areas of the facility with Licensee. LPA interviewed staff(S1), random children, Licensee and random parents during today's investigation. LPA conducted observations during today's investigation. LPA reviewed a child file and a staff file during today's investigation.

A copy of the Child Care Facility Roster and pertinent documents of complaint investigation were obtained during today's investigation.

**Continue on next page**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
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 07-CC-20260604122137
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: LOPEZ, JAQUELINE
FACILITY NUMBER: 274416060
VISIT DATE: 06/08/2026
NARRATIVE
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During today's investigation, day care home is observed to be kept clean and orderly. Based on interviews, children get injured, but not due to lack of supervision to children in care. LPA did not observe any animal feces during today's investigation. Licensee self-admitted that there was one time, a child(C1) was allowed in the offlimit areas of the facility to help the child to adjust into the new environment of the day care home, but the child did not get any exposure to any animal feces. Based on interviews, the children are not allowed to go to the offlimit areas of the home and home is kept clean of any animal feces. Based on observations, interviews and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiency issued during today's investigation. Appeal rights were provided.

Exit interview conducted and report is reviewed with Licensee, Jaqueline Lopez.

A notice of site visit is issued and must remain posted for 30 days.
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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