434409640-7-20-2023-07-CC-DSTN-CUC36X-20230802175900

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434409640
Report Date: 07/20/2023
Date Signed: 07/20/2023 10:42:17 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
05/11/2023 and conducted by Evaluator Janette Cruz

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230511110314

FACILITY NAME:	HERNANDEZ, LORENA		FACILITY NUMBER:	434409640
ADMINISTRATOR:	LORENA HERNANDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 334-9528
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95123
CAPACITY:	14	CENSUS: 7	DATE:	07/20/2023
		UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Lorena Hernandez		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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9

Licensee is not meeting the minimum qualifications

Licensee is not providing healthful accommodations to the daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Janette Cruz conducted an unannounced follow up complaint investigation and met with Lorena Hernandez, Licensee. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of allegations listed above was conducted by LPA Cruz. Based on the available evidence including observations, record reviews and interviews completed for this complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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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