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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415601
Report Date: 09/19/2024
Date Signed: 09/19/2024 01:18:10 PM

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
07/18/2024 and conducted by Evaluator Jennifer Beehler
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240718152724
FACILITY NAME:PEPPERTREE SCHOOLS RANCH HOUSEFACILITY NUMBER:
434415601
ADMINISTRATOR:DANNA D MATTHEW OSBORNFACILITY TYPE:
850
ADDRESS:14969 LOS GATOS ALMADEN ROADTELEPHONE:
(408) 626-9200
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:24CENSUS: 14DATE:
09/19/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Danna OsbornTIME COMPLETED:
01:25 PM
ALLEGATION(S):
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Staff inappropriately restrained daycare child.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jennifer Beehler & Marilou Monaco made an unannounced Complaint Inspection. LPA met with Director, Danna Osborn and advised the purpose of today's visit is to deliver findings.

Based on the information gathered during the investigation process through interviews, police report and other relevant documents, the Department found that staff did inappropriately restrain a child in care. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. One Type B deficiency was issued on the following LIC9099-D. Exit interview conducted and report was reviewed with the Director Osborn. NOTICE OF SITE VISIT WAS PROVIDED AND MUST REMAIN POSTED FOR 30 DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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-20240718152724
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: PEPPERTREE SCHOOLS RANCH HOUSE
FACILITY NUMBER: 434415601
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2024
Section Cited
CCR
101223(a)(3)
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Personal Rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Director Danna Osborn will submit a written plan by Thursday 09/26/2024, to ensure that children's personal rights will not be violated in the future.
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This requirement was not met as evidenced by: Staff restrained a day care child this poses a potential risk to the health and safety and personal rights 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: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
07/18/2024 and conducted by Evaluator Jennifer Beehler
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240718152724

FACILITY NAME:PEPPERTREE SCHOOLS RANCH HOUSEFACILITY NUMBER:
434415601
ADMINISTRATOR:DANNA D MATTHEW OSBORNFACILITY TYPE:
850
ADDRESS:14969 LOS GATOS ALMADEN ROADTELEPHONE:
(408) 626-9200
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:24CENSUS: 14DATE:
09/19/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Danna OsbornTIME COMPLETED:
01:25 PM
ALLEGATION(S):
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Staff pushed daycare child.
Daycare children left in soiled diapers for extended period of time.
Daycare children sustained unexplained injury while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jennifer "Jen" Beehler & Marilou Monaco met with Danna Osborn, Director, for an unannounced follow up complaint investigation. Purpose of today's investigation was to deliver findings. Based on interviews, observations, record reviews, and evidence gathered during the investigation process, 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. Exit interview conducted and report was reviewed with the Director Osborn. No deficiencies issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3