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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 354416103
Report Date: 12/15/2025
Date Signed: 12/15/2025 10:53:26 AM

Substantiated


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
11/14/2025 and conducted by Evaluator Andy Yang
COMPLAINT CONTROL NUMBER: 07-CC-20251114112924
FACILITY NAME:HOLLISTER CHILD DEVELOPMENT CENTER, LLCFACILITY NUMBER:
354416103
ADMINISTRATOR:ALMA MAY BAYANI, PSYDFACILITY TYPE:
840
ADDRESS:331 GATEWAY DRIVETELEPHONE:
(831) 635-9284
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:56CENSUS: 20DATE:
12/15/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Alma May BayaniTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Personal Rights- Staff shouted at child to wake up and threw water in her face
INVESTIGATION FINDINGS:
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On 12/15/2025, Licensing Program Analyst (LPA) Andy Yang conducted an unannounced complaint investigation. LPA met with Director, Alma May Bayani to deliver the complaint allegation listed above. Present for today’s inspection were Director (2) staff, (20) preschool age children. LPA toured the indoor areas of the facility.

Complaint investigation comprised of interviews with the Director and staff, and records review and Declaration Statements received. Based on the result of the investigation, although there was no indication of staff (S1) shouting at child (C1), through records reviewed and Declaration statement, S1 admitted that on November 7th, 2025, she had put water on C1’s face.

***Continue Page 2***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025
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 3
Control Number 07-CC-20251114112924
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: 354416103
VISIT DATE: 12/15/2025
NARRATIVE
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Based on LPA’s observation and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED California Code of Regulations, 101223(a)(3), and Type B deficiency is issued on attached LIC 9099D.


A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with the Director, Alma May Bayani.
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20251114112924
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: 354416103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/15/2026
Section Cited
CCR
101223(a)(3)
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(a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule ... other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting ...medication or aids to physical functioning. This requirement is not met as evidence by:
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By Plan of Correction due date of 1/15/2025, Director will provide copy of training agenda on personal rights, review LIC613a, review Personal RIghts Video on CCLD website, and copy of staff attendance sheet.
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Based on records review and interviews, staff (S1) had put water on child’s (C1) face, which posed a potential health, safety, or personal rights risk to person 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: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3