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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073404172
Report Date: 12/17/2021
Date Signed: 12/17/2021 07:02:24 PM

Substantiated


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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/03/2021 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20210803150044
FACILITY NAME:VERDUZCO, LISAFACILITY NUMBER:
073404172
ADMINISTRATOR:VERDUZCO, LISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 234-9988
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:14CENSUS: DATE:
12/17/2021
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:LISA VERDUZCOTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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NEGLECT/LACK OF SUPERVISION- Provider leaves children unattended
INVESTIGATION FINDINGS:
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LICENSING PROGRAM ANALYST ALEXANDER MET WITH LICENSEE LISA VERDUZCO TO DELIVER THE FINDINGS TO THE ABOVE COMPLAINT ALLEGATIONS.

UPON ARRIVAL THERE ARE _ CHILDREN IN CARE ALONG WITH LICENSEE AND HUSBAND/ASSISTANT RYAN VERDUZCO. DURING THIS ANALYST'S LAST VISIT INTERVIEWS WERE CONDUCTED WITH LICENSEE AND CHILDREN IN CARE. FURTHER INVESTIGATION WAS CONDUCTED.

BASED ON LPAs OBSERVATIONS AND INTERVIEWS WHICH WERE CONDUCTED AND RECORD REVIEWS, THE PREPONDERANCE OF EVIDENCE STANDARD HAS BEEN MET, THEREFORE THE ABOVE ALLEGATION IS FOUND TO BE SUBSTANTIATED. California Code of Regulations, (Title 22, Division 1 & Chapter 12), are being cited on the attached LIC. 9099D.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
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 2
Control Number 02-CC-20210803150044
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: VERDUZCO, LISA
FACILITY NUMBER: 073404172
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2021
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. REQUIREMENT WAS NOT MET:
LICENSEE HAS LEAVES CHILDREN UNATTENDED BY BEING IN ANOTHER ROOM WHILE CHILDREN ARE IN CARE.
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LICENSEE SHALL ENSURE THAT CHILDREN ARE VISUALLY SUPERVISED AT ALL TIMES WHILE IN HER CARE. LICENSEE SHALL PROVIDE A WRITTEN ESSAY ON THE DANGER OF LEAVING CHILDREN UNATTENDED WHILE IN CARE AND SUBMIT TO COMMUNITY CARE LICENSING BY 12/31/21.
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
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