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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444407941
Report Date: 07/24/2025
Date Signed: 07/24/2025 10:18:11 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
06/05/2025 and conducted by Evaluator Pedro Solorio-Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250605172112
FACILITY NAME:MELGOZA, LOURDESFACILITY NUMBER:
444407941
ADMINISTRATOR:MELGOZA, LOURDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 763-0799
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 9DATE:
07/24/2025
UNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Lourdes MelgozaTIME COMPLETED:
10:29 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider restrained child in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/24/2025 Licensing Program Analyst (LPA) Pedro Solorio-Gutierrez came to deliver findings. LPA met with licensee Lourdes Melgoza. LPA toured the indoor and outdoor areas of the facility.

During the investigation, LPA conducted observations, interviewed licensee, assistant, parents, and children.

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.

Exit interview conducted and report was reviewed with the licensee, Lourdes Melgoza.

There were no deficiencies cited.

A Notice of Site Visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Pedro Solorio-Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
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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