<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416299
Report Date: 04/28/2022
Date Signed: 04/28/2022 03:34:36 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
03/23/2022 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220323101614
FACILITY NAME:LAZO SAMANIEGO, HERLINDAFACILITY NUMBER:
434416299
ADMINISTRATOR:LAZO SAMANIEGO, H.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(669) 278-5143
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:14CENSUS: 4DATE:
04/28/2022
UNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Helinda LazoTIME COMPLETED:
03:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Staff hit daycare child
2. Staff pulled daycare child's hair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Anna Morales conducted an unannounced follow-up complaint investigation and met with Licensee Herlinda Lazo. The purpose of today's follow-up complaint investigation is to deliver investigation findings.

The investigation of the allegations listed above was conducted by LPA Morales. Based on observations and interviews completed for this complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
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 1