430700549-12-28-2023-07-CC-GKUN-CYYPAA-20231229100825

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430700549
Report Date: 12/13/2023
Date Signed: 12/28/2023 08:54:00 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
11/08/2023 and conducted by Evaluator Anna Morales

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20231108120516

FACILITY NAME:	SAN JOSE DAY NURSERY		FACILITY NUMBER:	430700549
ADMINISTRATOR:	ELENA JOLLY		FACILITY TYPE:	850
ADDRESS:	33 NORTH 8TH STREET		TELEPHONE:	(408) 288-9667
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	88	CENSUS: 47	DATE:	12/13/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rhysie Montano/Enrollment Specialist		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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1. Facility staff did not treat a child with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anna Morales conducted an Subsequent visit to deliver the finding(s) for the above allegation. LPA met with Rhysie Montano, Enrollment Specialist.

LPA conducted interviews with Staff and other parties involved and observed Child(C1)'personal items, and based on the information obtained, Staff addressed Child (C1) preference while at the Center.

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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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