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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 354416102
Report Date: 04/23/2025
Date Signed: 04/23/2025 11:54:44 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
04/01/2025 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250401100031
FACILITY NAME:HOLLISTER CHILD DEVELOPMENT CENTER, LLCFACILITY NUMBER:
354416102
ADMINISTRATOR:ALMA MAY BAYANI, PSYDFACILITY TYPE:
830
ADDRESS:331 GATEWAY DRIVETELEPHONE:
(831) 635-9284
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:20CENSUS: 11DATE:
04/23/2025
UNANNOUNCEDTIME BEGAN:
08:52 AM
MET WITH:Dominique Garza, Sabrina Chavarria and Jennifer De la Cruz SuarezTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility staff did not report day care child's injury to parents.
Staff did not change diapers for a child when needed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mandeep Kaur met with Infant aid/Floater, Dominique Garza, Admin Assistant, Sabrina Chavarria and Infant aid, Jennifer De La Cruz Suarez, for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. LPA conducted observations, interviewed staff and random parents during the investigation. LPA toured the indoor areas of the facility during today's investigation.

Based on interviews, observations, records review and evidence gathered during the investigation process, it is concluded that although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. The allegations are UNSUBSTANTIATED.

Admin assistant stated that Director, Alma May Bayani has authorized Admin assistant to sign the report.

**Continue on next page**

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
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 2
Control Number 07-CC-20250401100031
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HOLLISTER CHILD DEVELOPMENT CENTER, LLC
FACILITY NUMBER: 354416102
VISIT DATE: 04/23/2025
NARRATIVE
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No deficiency issued during today's investigation.

Exit interview conducted and report was reviewed with Admin assistant, Sabrina Chavarria.


Notice of site visit issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2