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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444415939
Report Date: 12/08/2023
Date Signed: 12/08/2023 02:40:55 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
10/31/2023 and conducted by Evaluator Teodoro Trujillo
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20231031150208

FACILITY NAME:VASQUEZ, LORENAFACILITY NUMBER:
444415939
ADMINISTRATOR:LORENA VASQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 247-8372
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: DATE:
12/08/2023
UNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Lorena VasquezTIME COMPLETED:
12:17 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared adults present in home.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Teodoro Trujillo and Liridon Fici met with Lorena Vasquez. Additional adults present were, Estephania, Alma, Jesus Morales who has a licensed day care, licensee 12 year old daughter and 3 month old grandchild, two infants arrived during visit.

Based on interviewes with staff, children in care guardian/representative, LPA's own observations and children file review, the allegations listed above could not be proved or disproved.

LPA concludes that although the allegations may have happened or are valid, there were not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with licensee Lorena Vasquez.

NOTICE OF SITE VISIT WAS POSTED AND SHALL REMAIN POSTED FOR 30 DAYS ALONG SIDE TYPE A DEFICIENY.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
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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