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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430700549
Report Date: 07/20/2023
Date Signed: 07/21/2023 09:39:32 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
06/19/2023 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230619141518
FACILITY NAME:SAN JOSE DAY NURSERYFACILITY NUMBER:
430700549
ADMINISTRATOR:ELENA JOLLYFACILITY TYPE:
850
ADDRESS:33 NORTH 8TH STREETTELEPHONE:
(408) 288-9667
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:88CENSUS: 46DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Angela Gomez/Riki LopezTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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1. Staff handled child in a rough manner.
2. Staff do not accord children dignity when changing diapers
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted an subsequent complaint investigation for the above allegations. LPA met with Executive Director Angela Gomez and Riki Lopez and discussed the above allegations

LPA reviewed that two incident reports (May 4,2023 and June 13,2023) stating that S1 was observed to have handled children, C1 and C2, in rough manner. On 5/4/23, a parent (P1) observed staff (S1) yank child (C1) in C1's classroom. As a result of this allegation, S1 was given a Notice of Complaint (signed and dated on 5/11/23) by the Director which states, "This letter serves as a notice of a parent's complaint regarding your behavior with their child. Any further complaint of rough handling with any child will result in further disciplinary action".
(1/2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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-20230619141518
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SAN JOSE DAY NURSERY
FACILITY NUMBER: 430700549
VISIT DATE: 07/20/2023
NARRATIVE
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Based on incident report, the second incident occurred on 6/13/23 in the playground. Parent (P2) observed S1 handling a child in a rough manner. S1 stated that she/he observed a stick in C2's mouth and grabbed C2 to remove the stick. This incident was captured on the security camera. LPA obtained and reviewed the video. Director stated she reviewed the video and agreed that S1 could have handled the child in a gentler manner. A subsequent warning letter (Final Warning) was given to S1 for this incident.

Based on the information obtained through interviews with staff and parents and reviewing supporting documentation, staff (S1) was witnessed by at least ten(10) individuals handling children including C3 (Child) in a rough manner on more than one occasion.

Based on the information obtained through observation and interviews (with staff and parents), the staff in Classrooms 4 and in 5, change diapers and clean the children in a manner that does not accord the children's dignity. Staff changes a child in the bathroom by having the child bend over while their hands touch the floor to ensure proper hygiene while wiping.

Three of the staff and three parents interviewed stated cleaning the children in this manner does not accord children dignity, is odd, and out of the ordinary. Director stated this is not how they train their staff to change diapers or clean children and long time staff adopted the practice without the facility’s direction.

Based on the information gathered during the investigation, the preponderance of evidence standard has been met. Therefore, the above allegation is SUBSTANTIATED.
Deficiencies are being cited. Exit interview conducted with Director where this report was discussed. Appeal rights were also provided during visit.
NOTICE OF SITE VISIT WAS ISSUED AND DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.





SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 07-CC-20230619141518
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JOSE DAY NURSERY
FACILITY NUMBER: 430700549
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
07/21/2023
Section Cited
CCR
101223(a)(3)
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Personal Rights(a)(3) Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature.
This requirement was not met as evidenced by:
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 Director stated that she will submitt a written plan outlining policy for staff and training that will ensure that children's personal rights are not violated and submit by the POC date
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Based on interviews and record review, (S1) Staff handled children in a rough manner, which poses an immediate risk to the health and safety of children in care.
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Upon receipt, Director shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
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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: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20230619141518
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JOSE DAY NURSERY
FACILITY NUMBER: 430700549
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/03/2023
Section Cited
CCR
101223(a)(1)
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Personal Rights(a)(1):The licensee shall ensure that each child is accorded the following personal rights:(1)To be accorded dignity in his/her personal relationships with staff and other persons.
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 Director stated that they are no longer practicing this method of cleaning/changing the children and will submit a plan the entails how they will change/clean the children by the POC date



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This requirement was not met as evidenced by: Based on interviews and observation, the staff in Classrooms 4 and in 5, change diapers and clean the children in a manner that does not accord the children's dignity. This poses a risk to the health, safety, and personal rights of children 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: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
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