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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434414670
Report Date: 02/10/2026
Date Signed: 02/10/2026 10:49:04 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
02/04/2026 and conducted by Evaluator Jennifer Beehler
COMPLAINT CONTROL NUMBER: 07-CC-20260204101937
FACILITY NAME:ACTION DAY PRIMARY PLUSFACILITY NUMBER:
434414670
ADMINISTRATOR:JENNY DO& MARIA LOPEZFACILITY TYPE:
830
ADDRESS:2174 LINCOLN AVENUETELEPHONE:
(408) 266-8188
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY:50CENSUS: 43DATE:
02/10/2026
UNANNOUNCEDTIME BEGAN:
08:33 AM
MET WITH:Jamie Ferguson - Facility RepresentativeTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not provide adequate supervision to day care infant, resulting in the infant eloping unnoticed from the facility.
INVESTIGATION FINDINGS:
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On 02/10/2026, Licensing Program Analyst (LPA) Jennifer "Jen" Beehler conducted an unannounced 10 Day Complaint Investigation. Upon arrival, LPA was greeted by Facility Representative Jamie Ferguson and provided access to the facility. LPA provided the reason for the visit, toured the facility and collected the census. There were 43 infants and 11 staff (6 teachers and 5 aides) present which is compliant with ratio and capacity requirements.

LPA conducted interviews, collected relevant documentation and observed the facility. Based on the self reported incident that occurred on 02/04/2026, it was determined that Child #1 (C#1) did elope from the facility without staff knowledge. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Continued Page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
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-20260204101937
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: ACTION DAY PRIMARY PLUS
FACILITY NUMBER: 434414670
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/11/2026
Section Cited
CCR
101429(a)(1)
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101429 Responsibility for Providing Care and Supervision for Infants (a)(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.

This requirement has not been met as evidenced by:
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Prior to the Department's visit the facility took corrective action by increasing the height of door handles making them inaccessible to children's reach. A training has been scheduled for 02/11/2026 to address supervision and transition procedures. A full review of the situation has been investigated and appropriate action and changes have been instituted to ensure children are supervised at all times and the facility grounds are secure.
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Based on LIC624 Incident report provided by Facility Representative Jamie Ferguson on 02/04/2026, C#1 did elope from the facility without staff knowledge. This poses an immediate 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: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20260204101937
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: ACTION DAY PRIMARY PLUS
FACILITY NUMBER: 434414670
VISIT DATE: 02/10/2026
NARRATIVE
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Due to this investigation, a Type A citation is cited along with an immediate civil penalty. More details are provided on the attached LIC809-D and LIC421IM.

LPA, Jennifer Beehler, informed Facility Representative, Jamie Ferguson, that this report dated 02/10/2026 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Jennifer Beehler, informed Facility Representative, Jamie Ferguson, to provide a copy of this licensing report dated 02/10/2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

LPA provided the facility with an LIC9224 with today's date.

Exit interview conducted with Facility Representative, Jamie Ferguson. Report was reviewed and provided to Facility Representative, Jamie Ferguson along with appeal rights.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3