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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417746
Report Date: 04/28/2025
Date Signed: 07/10/2025 08:51:07 AM

Unsubstantiated


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
03/14/2025 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250314143528
FACILITY NAME:RAMIREZ VASQUEZ, ANNETTFACILITY NUMBER:
434417746
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
04/28/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Annett Ramirez VasquezTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Personal Rights: Licensee hit child in care
INVESTIGATION FINDINGS:
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On 04/28/2025, Licensing Program Analysts (LPAs) Deanna Villagrana, Pedro Solorio Gutierrez and Albert Mendoza conducted an unannounced complaint inspection at the facility. The purpose of the inspection was to deliver the findings for the above listed allegation. LPAs met with Licensee, Annett Ramirez Vasquez to discuss the findings of the complaint investigation. A tour of the home was conducted, and a census was taken.
During the course of the investigation, Interviews were conducted. Additionally, LPA reviewed and obtained records pertaining to the above-mentioned allegation. Interviews conducted and records reviewed revealed conflicting information and inconsistent statements to corroborate the allegation, that licensee hit day care children.
The investigation revealed through interviews, and review of records, that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Report Continued on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Albert Mendoza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025
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-20250314143528
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: RAMIREZ VASQUEZ, ANNETT
FACILITY NUMBER: 434417746
VISIT DATE: 04/28/2025
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited. Exit interview conducted with Annett Ramirez Vasquez. A copy of this report and Appeal Rights were provided and discussed by licensee, Annett Ramirez Vasquez

This is a Amended Report.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Albert Mendoza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
03/14/2025 and conducted by Evaluator Deanna Villagrana
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250314143528

FACILITY NAME:RAMIREZ VASQUEZ, ANNETTFACILITY NUMBER:
434417746
ADMINISTRATOR:ANNETT RAMIREZ VASQUEZFACILITY TYPE:
810
ADDRESS:2623 OPHELIA AVENUETELEPHONE:
(408) 449-2513
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:6CENSUS: 4DATE:
04/28/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Annett Ramirez VasquezTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Personal Rights: Licensee prevented child from going to the bathroom
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Deanna Villagrana, Pedro Solorio Gutierrez and Albert Mendoza met with licensee Annett Ramirez Vasquez to deliver findings for the above allegations. LPAs explained the nature of the visit. Present were licensee and three day care children. An additional child arrived during visit.

Based on interviews conducted, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiency was cited.

Notice of site visit was issued and must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20250314143528
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: RAMIREZ VASQUEZ, ANNETT
FACILITY NUMBER: 434417746
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
04/29/2025
Section Cited
CCR
102423(a)(4)
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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
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Licensee will submit a statement stating she understands regulation and will not hit children as a form of punishment to CCLD by POC date.
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This requirement was not met as evidenced by Licensee hit a child on the hand causing the child to obtain a red hand. 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: 04/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4