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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274416218
Report Date: 07/16/2024
Date Signed: 07/16/2024 10:30:18 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
04/29/2024 and conducted by Evaluator Elizabeth Larios
COMPLAINT CONTROL NUMBER: 07-CC-20240429095715
FACILITY NAME:SAN ARDO EARLY EDUCATION & CHILD CARE CENTERFACILITY NUMBER:
274416218
ADMINISTRATOR:GUADALUPE LAZOFACILITY TYPE:
850
ADDRESS:59921 JOLON ROADTELEPHONE:
(831) 202-1223
CITY:SAN ARDOSTATE: CAZIP CODE:
93450
CAPACITY:24CENSUS: 0DATE:
07/16/2024
ANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:Melina LedesmaTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Lack of supervision caused child to sustain injuries.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Larios conducted an announced inspection to deliver the complaint allegation listed above. LPA met with Capslo Administrative Assistant, Melina Ledesma at Capslo location in 851 5th St. Suite W Gonzalez, CA 93926 due to facility being close for the summer. LPA explained the purpose of today's visit.

Based on interviews conducted, records obtained, and evidence gathered during the investigation process, it is concluded that although the allegation listed on this complaint (Lack of supervision caused child to sustain injuries.) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur due to lack of supervision. The allegation is therefore UNSUBSTANTIATED.

No deficiency was cited. Exit interview was conducted, where this report was reviewed and discussed with Melina Ledesma.

====CONTINUED ON LIC 9099-C====.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
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 4
Control Number 07-CC-20240429095715
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: SAN ARDO EARLY EDUCATION & CHILD CARE CENTER
FACILITY NUMBER: 274416218
VISIT DATE: 07/16/2024
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: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4