434415176-4-21-2022-07-CC-DSTN-CEBVHA-20220511162646

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434415176
Report Date: 04/21/2022
Date Signed: 04/21/2022 02:56:58 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/04/2022 and conducted by Evaluator Ofelia Calivo

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220304115048

FACILITY NAME:	ACTION DAY PRIMARY PLUS		FACILITY NUMBER:	434415176
ADMINISTRATOR:	PAULA SCHROEDER		FACILITY TYPE:	830
ADDRESS:	2154 LINCOLN AVENUE		TELEPHONE:	(408) 266-8188
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY:	20	CENSUS: 13	DATE:	04/21/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Stephanie Bate		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff handled children in a rough manner
Children were force fed by staff
Staff restrained children
Staff did not ensure children wore adequate clothing to keep them warm
Staff did not ensure that children were in a safe position while sleeping
Staff did not maintain a comfortable temperature in the facility
Staff interfered with child's sleep
Staff did not follow infants feeding plan

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ofelia Calivo conducted an unannounced complaint inspection investigation and met with Stephanie Bate, Assistant Director. Purpose of today’s inspection: deliver investigation findings.
Based on observations, interviews and police reports, 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 that the alleged violations did or did not occur.

The allegations are thus UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Ofelia Calivo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

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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