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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415531
Report Date: 09/30/2022
Date Signed: 09/30/2022 01:44:49 PM

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
08/16/2022 and conducted by Evaluator Harsimran Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220816090627
FACILITY NAME:BRIGHT HORIZONS AT SUNNYVALEFACILITY NUMBER:
434415531
ADMINISTRATOR:DONALDSON, KIMEESEANFACILITY TYPE:
830
ADDRESS:1010 SUNNYVALE-SARATOGA AVENUETELEPHONE:
(669) 216-4384
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:80CENSUS: 10DATE:
09/30/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Geeta NezamfarTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Staff did not ensure a safe and healthful environment for infant was injured while in care
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Kaur conducted an unannounced complaint investigation and met with Director, Gita Nezamfar. Purpose of today’s inspection: deliver investigation findings. LPA also observed 10 infants with 4 staff at the facility during today's complaint investigation.

Based on the available evidence, record reviews and interviews conducted, it is concluded that the a day care child sustained injuries while in the facility's care. Facility self reported this incident to the department. The preponderance of evidence standard has thus been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12 & Chapter 1), is being cited on the attached LIC 9099-D. Copy of appeal rights provided to Geeta Nezamfar. Director, prior to conclusion of today’s inspection.


A Notice of Site Visit is issued and must be posted near the entrance of the facility along with a copy of today's report for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
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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Control Number 07-CC-20220816090627
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: BRIGHT HORIZONS AT SUNNYVALE
FACILITY NUMBER: 434415531
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/30/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2022
Section Cited
HSC
101223(a)(2):
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To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:

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Deficiency has been cleared. Director recommending to families to use plastic containers to feed infants.
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 Based on record reviews and interviews,. staff admitted to the allegation. Specifically, she accidentally drop glass bowl provided by parent and their infant sustained injury. This poses a potential health and safety risk to 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: Diana Stephenson
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2