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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015701169
Report Date: 08/06/2025
Date Signed: 08/06/2025 10:36:47 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2025 and conducted by Evaluator Kassandra Medrano
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250625135606
FACILITY NAME:CAMPOS GUZMAN, DAISYFACILITY NUMBER:
015701169
ADMINISTRATOR:DAISY CAMPOS GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 953-0653
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:14CENSUS: 6DATE:
08/06/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Daisy Campos GuzmanTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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9
Licensee does not ensure infants sleep comfortably.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Kassandra Medrano conducted an unannounced inspection in order to deliver findings on the complaint investigation for the above allegation. LPA Medrano met with the Licensee, Daisy, to discuss complaint allegations findings. Present in the facility were licensee, adult staff, and 6 children.

It was alleged that staff do not ensure infants are able to sleep while in care. LPA Medrano conducted interviews with staff and parents and gathered additional information through observations. The findings revealed that while infants are sleeping in playpens, other children throw items into the playpens, disrupting their rest. Based on the evidence collected, the allegation is deemed SUBSTANTIATED, meaning it is valid and supported by a preponderance of the evidence.

California Code of Regulations, Title 22, 102423(a)(2), deficiencies are being cited on the following page(s):
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2025 and conducted by Evaluator Kassandra Medrano
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250625135606

FACILITY NAME:CAMPOS GUZMAN, DAISYFACILITY NUMBER:
015701169
ADMINISTRATOR:DAISY CAMPOS GUZMANFACILITY TYPE:
810
ADDRESS:4627 NORWOOD TERR.TELEPHONE:
(510) 953-0653
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:9CENSUS: 6DATE:
08/06/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Daisy Campos GuzmanTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is not home 80% of the time.
INVESTIGATION FINDINGS:
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4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kassandra Medrano conducted an unannounced inspection in order to deliver findings on the complaint investigation for the above allegation. LPA Medrano met with the Licensee, Daisy, to discuss complaint allegations findings. Present in the facility were licensee, adult staff, and 6 children.

It was alleged that the Licensee, Daisy, is not present in the home 80% of the operational hours. Based on LPAs observations, record reviews, and interviews which were conducted. The allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report and appeal rights were reviewed and provided to Licensee, Daisy Campos.

Notice of Site visit was observed to be posted and shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 52-CC-20250625135606
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CAMPOS GUZMAN, DAISY
FACILITY NUMBER: 015701169
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/13/2025
Section Cited
CCR
102423(a)(2)
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102423(a)(2) Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
This requirement was not met as evidenced by:
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The licensee shall submit a written statement acknowledging their understanding of the applicable regulations, along with a corrective action plan outlining measures to ensure that infants and children are provided with a safe and comfortable sleeping environment.
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Based on interviews and observations it was found that the children have been unable to sleep or their sleep has been disturbed in the facility. This poses a potential health and safety risk to children in care.
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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: Wynn Norona
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4