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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435700330
Report Date: 01/28/2022
Date Signed: 04/18/2022 10:13:17 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2021 and conducted by Evaluator Jonathan Williams
COMPLAINT CONTROL NUMBER: 52-CC-20210802114200
FACILITY NAME:MARTINEZ LOPEZ, ANIBALFACILITY NUMBER:
435700330
ADMINISTRATOR:MARTINEZ LOPEZ, ANIBALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 669-3193
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94043
CAPACITY:14CENSUS: 0DATE:
01/28/2022
UNANNOUNCEDTIME BEGAN:
04:40 PM
MET WITH:TIME COMPLETED:
04:55 PM
ALLEGATION(S):
1
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9
Licensee inappropriately touched daycare children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jonathan Williams and Licensing Program Manager (LPM) Diane Perez arrived at the facility unnanounced for the purposes of delivery of Revocation and Expedited Temporary Suspension Order (TSO) for the above allegation. LPA and LPM were met by an adult woman and no children in care. Licensee (Anibal Martinez Lopez) was not present.

The allegation that Licensee inappropriately touched daycare children is UNSUBSTANTIATED. Based on the investigation conducted by Investigator Eddie Phung of Investigation Bureau (IB), there is not a preponderance of evidence to prove the allegation did or did not occur, meaning the allegation may have happened or is valid.

This report was mailed to the Licensee's current address for signature.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
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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