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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 274415983
Report Date: 04/09/2025
Date Signed: 04/09/2025 11:38:17 AM

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
01/30/2025 and conducted by Evaluator Martha Jimenez-Villanueva
COMPLAINT CONTROL NUMBER: 07-CC-20250130143940
FACILITY NAME:CONTRERAS, ADELAFACILITY NUMBER:
274415983
ADMINISTRATOR:ADELA CONTRERASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(941) 580-7943
CITY:GREENFIELDSTATE: CAZIP CODE:
93927
CAPACITY:14CENSUS: 4DATE:
04/09/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Adela ContrerasTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Provider hit child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Martha Jimenez-Villanueva conducted an unannounced inspection to deliver findings for the above allegation. LPA met with Adela Contreras explained the purpose of today's visit. Present at home licensee, her Assistant/daughter and her husband. LPA observed four children in care: one infant and three toddlers.

Based on interviews conducted, records obtained, and evidence gathered during the investigation process, it is concluded that although the allegation listed on this complaint may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegation is therefore UNSUBSTANTIATED.

Exit interview was conducted, where this report was reviewed and discussed with Adela Contreras in Spanish. 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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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