434415313-3-15-2021-07-CC-ASTR-C2BPJ4-20210422112052

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434415313
Report Date: 03/15/2021
Date Signed: 03/15/2021 04:00:48 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
02/08/2021 and conducted by Evaluator Marilou Monico

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20210208110150

FACILITY NAME:	SPRINGS OF LIFE CHRISTIAN PRESCHOOL		FACILITY NUMBER:	434415313
ADMINISTRATOR:	DENHOLM, JULIE		FACILITY TYPE:	850
ADDRESS:	3151 UNION AVENUE		TELEPHONE:	(408) 827-5814
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	45	CENSUS: 25	DATE:	03/15/2021
		ANNOUNCED	TIME BEGAN:	03:25 PM
MET WITH:	Julie Denholm		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Child sustained injury while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marilou Monico conducted an announced subsequent complaint tele-inspection to deliver findings via Facetime due to Covid-19 pandemic. LPA met with Executive Director, Julie Denholm. Executive Director was advised that this Complaint Investigation Report (LIC 9099) will be emailed to her(director@springsoflifechristianpreschool.org). Facility's reply to the email within 24 hours will serve as acknowledgement that the report was received.

Based on interviews and documents that were obtained during the investigation, although the allegation that child sustained injury while in care may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. Therefore, the allegation is found to be UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

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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