434409500-6-17-2022-07-CC-DSTN-CFLVLR-20220621163223

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434409500
Report Date: 06/17/2022
Date Signed: 06/17/2022 03:28:09 PM

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
04/01/2022 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220401153518

FACILITY NAME:	MORENO VEGA, NORMA		FACILITY NUMBER:	434409500
ADMINISTRATOR:	MORENO VEGA, NORMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 835-6694
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94085
CAPACITY:	14	CENSUS: 14	DATE:	06/17/2022
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Norma Moreno Vega		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Licensee hits day care children
Licensee pulled day care child's hair
Licensee handled day care children in a rough manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mel Matos conducted an unannounced follow up complaint investigation and met with Norma Moreno Vega, Licensee. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the complaint allegations listed in this complaint was conducted by LPA Mel Matos. Based on the available evidence, including observations of the Facility, documents reviewed, and interviews completed for the complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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