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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444407398
Report Date: 12/20/2024
Date Signed: 03/24/2025 01:14:34 PM

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
11/21/2024 and conducted by Evaluator Teodoro Trujillo
PUBLIC
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: 9DATE:
12/20/2024
ANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Maria RomeroTIME COMPLETED:
03:07 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child has sustained injuries due to lack of supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee Maria Romero to deliver complaint findings for above allegations. LPA explained the reason for the visit. Present during the visit with Licensee were assistant and nine day care children: eight preschool age and one school age.

During the course of this investigation, LPA conducted observation and reviewed documents. LPA also interviewed children and parents.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies were cited during today's visit. Exit interview was conducted and report was reviewed with Licensee Maria Romero.

A NOTICE OF SITE VISIT WAS PRINTED AND HANDED TO THE LICENSEE, MUST BE POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jennifer Pare
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
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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