<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274404456
Report Date: 10/06/2021
Date Signed: 10/11/2021 04:34:19 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, 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
07/28/2021 and conducted by Evaluator Elizabeth Larios
COMPLAINT CONTROL NUMBER: 07-CC-20210728150403
FACILITY NAME:VASQUEZ, LAURAFACILITY NUMBER:
274404456
ADMINISTRATOR:VASQUEZ, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 261-0609
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:14CENSUS: 5DATE:
10/06/2021
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Laura Vasquez TIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee does not reside in the home
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPAs), Elizabeth Larios & James Santos, conducted an unannounced complaint investigation to deliver investigation findings. LPAs met with Licensee, Laura Vasquez and explained the purpose of the inspection.

Based on observation, record reviews and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations is found to be SUBSTANTIATED. Licensee was cited on 10/06/2021 for Licensee does not reside in the home.

Exit interview was conducted, where this report was reviewed and discussed with Laura Vasquez.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
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 1