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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434411131
Report Date: 12/18/2023
Date Signed: 12/18/2023 03:41:34 PM

Substantiated


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
12/13/2023 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20231213094732
FACILITY NAME:VELAZQUEZ-RAMIREZ, MAURAFACILITY NUMBER:
434411131
ADMINISTRATOR:RAMIREZ, MAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 292-8517
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:14CENSUS: 10DATE:
12/18/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Maura Velazquez-RamirezTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Children in care are exposed to harsh chemicals
INVESTIGATION FINDINGS:
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Licensee Program Analyst (LPA) Deanna Villagrana met with licensee Maura Velazquez-Ramirez to open complaint for above allegation. LPA explained the nature of the visit. Present were licensee, licensee's husband, licensee's assistant Irma Hinojoza Minero and nine day care children including two infants. One additional child and assistant arrived during visit. Three of the children are licensee's grandchildren and one infant is assistant's grandchild.

Based on observation, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22, Division 12, Chapter 1) 102370(d)(1). LPA observed toothpaste and hair product accessible to children in the bathroom, potting soil, painting material, cleaning supplies and propane tanks accessible to children in the backyard. Licensee states children have not gone outside since last Wednesday, 12/13/2023 do the weather.

The following type A deficiency was cited on the attached page (809-D). Licensee was informed that failure to correct the deficiency by the specified Plan of
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
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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Control Number 07-CC-20231213094732
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: VELAZQUEZ-RAMIREZ, MAURA
FACILITY NUMBER: 434411131
VISIT DATE: 12/18/2023
NARRATIVE
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Correction (POC) Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

The following type A deficiency was cited on the attached page (809-D). Licensee was informed that failure to correct the deficiency by the specified Plan of Correction (POC) Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

LPA Deanna Villagrana informed licensee Maura Velazquez-Ramirez that this report dated 12/18/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Deanna Villagrana informed the licensee Maura Velazquez-Ramirez to provide a copy of this licensing report dated 12/18/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC9099 (FAS) - (06/04)
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Control Number 07-CC-20231213094732
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: VELAZQUEZ-RAMIREZ, MAURA
FACILITY NUMBER: 434411131
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/19/2023
Section Cited
CCR
102417(g)(4)
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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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Licensee removed items from the bathroom and will submit photos of cleaned up backyard to CCLD by POC date.
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This requirement was not met as evidenced by LPA observed LPA observed toothpaste and hair product accessible to children in the bathroom, potting soil, painting material, cleaning supplies and propane tanks accessible to children in the backyard. Licensee states children have not gone outside since last Wednesday, 12/13/2023 do the weather. This poses an immediate risk to the Health, Safety or Personal Rights to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023
LIC9099 (FAS) - (06/04)
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