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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444407398
Report Date: 11/22/2024
Date Signed: 11/22/2024 01:01:10 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
11/21/2024 and conducted by Evaluator Andrea Cortez
COMPLAINT CONTROL NUMBER: 07-CC-20241121153409
FACILITY NAME:ROMERO, MARIAFACILITY NUMBER:
444407398
ADMINISTRATOR:ROMERO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 288-0285
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 10DATE:
11/22/2024
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Maria RomeroTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Licensee is operating out of ratio-Ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Andrea Cortez conducted an unannounced complaint investigation. LPA met with Maria Romero and explained the purpose of today's inspection in Spanish.

LPA arrived at 9:14am and observed licensees’ mother, minor son, and 10 children in attendance.

Based on LPA’s observation the licensee left the assistant provider with 10 children and no qualified assistant. Which violates the capacity regulations for staff-children ratio The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Type A deficiency was cited on the attached LIC 9099-D. Copies of this report along with Type "A" deficiency to parents/guardians of children in care at this facility and to parents/guardians of children newly enrolled at this facility during the next 12 months. Exit interview was conducted, where this report was reviewed and discussed with Maria Romero. Appeal rights were given.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
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-20241121153409
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: ROMERO, MARIA
FACILITY NUMBER: 444407398
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
11/25/2024
Section Cited
CCR
102416.5(e)
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102416.5 Staff-Child Ratio
(e)If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care...linensee left assistant provider with with no adult assistant and10 children in attendance.
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POC due 11/25/24, lincesee to submit a written deficiency statement ensuring there is a qualified assistant meeting the staff-child ratio at all time.

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Based on observation, licensee left the assistant provider with 10 children and no adult assistant. Which violates the capacity regulations for staff-children ratio. This poses an immediate risk to the health, safety and personal rights of children in care.
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LIC9224 must be signed by all parents currently enrolled. LIC9224 and LIC9099 and 9099D must be provided to all future enrollments for the next 12 months and maintained in file.
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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: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3