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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004982
Report Date: 09/26/2024
Date Signed: 09/26/2024 02:39:26 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/09/2024 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240709145118
FACILITY NAME:VAZQUEZ, MARIA ISABELFACILITY NUMBER:
414004982
ADMINISTRATOR:VAZQUEZ, MARIA ISABELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 284-9261
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:14CENSUS: 10DATE:
09/26/2024
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Licensee, Maria Isabel VazquezTIME COMPLETED:
12:29 PM
ALLEGATION(S):
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Licensee does not reside in the daycare home.
INVESTIGATION FINDINGS:
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On September 26th, 2024 at approximately at 12:20pm, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, complaint investigation and met with Licensee, Maria Isabel Vazquez regarding the above allegation. Purpose of the inspection was explained and it was to deliver the findings of the pending complaint investigation.

Present in the home were licensee and assistant with 10 children (3 infants and 7 preschool age). As of this day, licensee is within capacity limits. All adults living and working in the home are fingerprinted cleared and associated. LPA conducted a health and safety inspection.

Complaint was received by the Department on 07/09/24. During the course of the investigation, LPA conducted file reviews, observations, interviews with staff, parents, and involved parties, as well as received pertinent documentation.

Continued on Page 2...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
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 3
Control Number 05-CC-20240709145118
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: VAZQUEZ, MARIA ISABEL
FACILITY NUMBER: 414004982
VISIT DATE: 09/26/2024
NARRATIVE
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Based on information gathered, LPA has determined that the licensee does not reside in the daycare home. LPA has conducted previous inspections where licensee is not present upon arrival and arrives minutes after. Licensee, Maria Isabel Vazquez was also found to be operating an unlicensed facility at 2118 Clarke Ave. Licensee had a licensed Family Child Care Home at said address from 04/2019-03/2023 and relocated to this facility address. LPA also conducted interviews, were multiple individuals stated that this facility is not her "primary residence".

Based on interviews, and record review which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, are being cited. Please refer to 9099D for more information.

Upon receipt of this report, Facility shall post the Notice of Site Visit. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain postings as required, will result in an immediate $100 civil penalty. This report is public and can be reviewed.

After today’s visit, an exit interview was conducted, report was reviewed and translated into Spanish by LPA Tapia-Mandujano and copy with appeal rights were provided to Licensee, Maria Isabel Vazquez.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20240709145118
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: VAZQUEZ, MARIA ISABEL
FACILITY NUMBER: 414004982
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2024
Section Cited
CCR
102352(h)(1)
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102352: Definitions: "(h) (1) "Home" means the licensee's residence as defined by Government Code Section 244... (b) There can only be one residence."

This requirement is not met by evidence of:
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The licensee needs to surrender the license or this location must be her primary home.

Office meeting may be scheduled.
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Based on interviews, observations, and record review, the facility did not comply with the section cited above as there is evidence to beleive that the licensee does not live in the home, which poses a potential health, safety or personal rights risk to persons 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: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC9099 (FAS) - (06/04)
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