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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444406684
Report Date: 01/31/2023
Date Signed: 02/01/2023 02:59:41 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, 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
11/07/2022 and conducted by Evaluator Elizabeth Larios
COMPLAINT CONTROL NUMBER: 07-CC-20221107144250
FACILITY NAME:COMMUNITY BRIDGES VISTA VERDE CHILD DEV CENTERFACILITY NUMBER:
444406684
ADMINISTRATOR:MARIA HURTADOFACILITY TYPE:
850
ADDRESS:1936 FREEDOM BLVD.TELEPHONE:
(831) 724-3749
CITY:FREEDOMSTATE: CAZIP CODE:
95019
CAPACITY:32CENSUS: 14DATE:
01/31/2023
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Maria Hurtado TIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Lack of supervision resulting in fracture
Facility failed to obtain medical treatment for injured child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Elizabeth Larios conducted an unannounced complaint investigation visit to deliver investigation finding. LPA met with Program Manager, Maria Hurtado explained the purpose of today's visit was to deliver the investigation findings for the above allegations.

Investigation Bureu Investigator, Elisia Rippe, conducted interviews (with parents, staff, and children), reviewed pertinent documents (such as children’s files and roster), and made facility observations in relation to the above allegations. Based on the available evidence, it is concluded that although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegations is thus UNSUBSTANTIATED.

As a result of this investigation, no deficiencies were cited. Exit interview was conducted and the report was reviewed with Maria Hurtado.

====CONTINUE ON LIC 9099-C====
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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
Control Number 07-CC-20221107144250
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: COMMUNITY BRIDGES VISTA VERDE CHILD DEV CENTER
FACILITY NUMBER: 444406684
VISIT DATE: 01/31/2023
NARRATIVE
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A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4