<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415486
Report Date: 12/11/2023
Date Signed: 12/11/2023 01:27:35 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
09/05/2023 and conducted by Evaluator Teodoro Trujillo
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230905100341
FACILITY NAME:CETINA DE NOVOA, CORINAFACILITY NUMBER:
434415486
ADMINISTRATOR:CETINA DE NOVOA, CORINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(669) 208-5693
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:14CENSUS: 10DATE:
12/11/2023
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Corina Cetinia De NovoaTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider does not reside in day care home.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Teodoro Trujillo and Deanna Villagrana met with Licensee Corina Cetinia De Novoa for an unannounced complaint visit to deliver findings for above allegation. Present were licensee, licensee's assistant Liliana Tumay and eight (8) day care children including two (2) infants. Two(2) additional infants arrived during the visit.

Based on LPA's observations, interviews and surveillance which were conducted, 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). Licensee Corina Cetina De Novoa does not reside in the home she is licensed in.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
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 3
Control Number 07-CC-20230905100341
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: CETINA DE NOVOA, CORINA
FACILITY NUMBER: 434415486
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/12/2023
Section Cited
HSC
1596.78(a)
1
2
3
4
5
6
7
"Family day care home" means a home that regularly provides care, protection, and supervision for 14 or fewer children, in the provider's own home, for periods of less than 24 hours per day, while the
1
2
3
4
5
6
7
The Licensee has been advised that she must reside "exclusively" in the home in which she is licensed as a large Family Child Care Home. Corina was informed the San Jose Regioanl Office will be consulting with CCLD Legal Office to determine next steps for facility.
8
9
10
11
12
13
14
parents or guardians are away, and is either a large family day care home or a small family day care home. This requirment was not met as evidenced by;
Licensee Corina Cetina De Novoa does not reside in the home she is licensed in. This poses an immediate risk to the Health, Safety or Personal Rights to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20230905100341
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: CETINA DE NOVOA, CORINA
FACILITY NUMBER: 434415486
VISIT DATE: 12/11/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPAs Teodoro Trujillo and Deanna Villagrana informed licensee Corina Cetina De Novoa that this report dated 12/11/2023 document(s) one (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, LPAs Teodoro Trujillo and Deanna Villagrana informed the licensee Corina Cetina De Novoa to provide a copy of this licensing report dated 12/11/2023 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.

Exit interview conducted and report was reviewed with licensee Corina Cetina De Novoa.



NOTICE OF SITE VISIT WAS POSTED AND SHALL REMAIN POSTED FOR 30 DAYS ALONG SIDE TYPE A DEFICIENCY.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3