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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 09:35:53 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
06/30/2023 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230630160100
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: DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Angela GomezTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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1. Staff handled day care child in a rough manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted an subsequent complaint investigation for the above allegation. 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 2
Control Number 07-CC-20230630160100
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 gathered during the investigation, the preponderance of evidence standard has been met. Therefore, the above allegation is SUBSTANTIATED.

A deficiency is being cited on Complaint #07-CC-20230619141518

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 2