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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408320
Report Date: 02/20/2025
Date Signed: 02/20/2025 12:45:15 PM

Unsubstantiated


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
12/27/2024 and conducted by Evaluator Indira Loza
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20241227114629
FACILITY NAME:VAN VELZEN, MARTAFACILITY NUMBER:
073408320
ADMINISTRATOR:VAN VELZEN, MARTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 878-5795
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:14CENSUS: 11DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Marta Van VelzenTIME COMPLETED:
12:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider is absent more than the allotted time per day.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On February 20, 2025 at 10:45am Licensing Program Analysts (LPAs) Indira Loza and Catherine Fernandes met with Licensee Marta Van Velzen to continue the complaint investigation for the above allegation. Present during today's visit were one infant, 10 preschoolers, two assistants, and the Licensee's spouse. LPAs conducted a tour of the facility for a Health and Safety check. During the course of the investigation LPAs observed the home, reviewed records, and conducted interviews.

Based on interviews from staff, parents and children in care, there is conflicting informantion on when the licensee is present. The Licensee has confirmed there are times when she has to leave the facility to attend appointments however, she stated she does ensure there is always staff to provide care to the children. LPA Loza has inspected the home on two separate occasions and the licensee has been present. Although 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 above allegation has been concluded as Unsubstantiated.
Exit interview conducted. Report, Notice of Site Visit, and Appeal Rights provided to Licensee Marta Van Velzen.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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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