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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415603
Report Date: 08/21/2024
Date Signed: 08/21/2024 03:11:06 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
08/13/2024 and conducted by Evaluator Jennifer Beehler
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240813153112
FACILITY NAME:PEPPERTREE SCHOOLS COTTAGE HOUSEFACILITY NUMBER:
434415603
ADMINISTRATOR:JO-ANN PANGANFACILITY TYPE:
850
ADDRESS:16035 LOS GATOS ALMADEN ROADTELEPHONE:
(408) 356-3211
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:43CENSUS: 27DATE:
08/21/2024
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Jo Ann PanganTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff did not keep facility free of rodents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPAs) Jennifer "Jen" Beehler and Marilou Monico met with Site Co-Directors, JoAnn Pangan & Danna Osborn, for a complaint inspection. LPAs interviewed staff, conducted an inspection of facility grounds including all classrooms, and kitchen area.

Based on interviews, rodents were observed outside the facility. Staff witnessed rat traps set in the laundry area. During today's inspection, LPAs observed rodent dropping in the kitchen cabinet. LPAs determined that staff failed to keep the facility grounds free of rodents. The preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

As a result, Type B deficiency was cited on the following page.

Exit interview conducted and report was reviewed with the Site Director, Danna Osborn. A Notice of Site Visit was given 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: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
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
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
08/13/2024 and conducted by Evaluator Jennifer Beehler
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240813153112

FACILITY NAME:PEPPERTREE SCHOOLS COTTAGE HOUSEFACILITY NUMBER:
434415603
ADMINISTRATOR:JO-ANN PANGANFACILITY TYPE:
850
ADDRESS:16035 LOS GATOS ALMADEN ROADTELEPHONE:
(408) 356-3211
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:43CENSUS: 27DATE:
08/21/2024
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Jo Ann PanganTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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9
Staff did not follow precautions to prevent the spread of illness.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jennifer "Jen" Beehler and Marilou Monico met with Jo Ann Pangan & Danna Osborn, Site Co- Directors, for a complaint inspection. Based on interviews, observation, and evidence gathered during the investigation process, it is concluded that although the allegation noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Site Director, Danna Osborn.

A Notice of Site Visit was given and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
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
Control Number 07-CC-20240813153112
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 COTTAGE HOUSE
FACILITY NUMBER: 434415603
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/28/2024
Section Cited
CCR
101238(a)(1)
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Buildings & Grounds: The licensee shall take measures to keep the center free of flies, other insects, and rodents.

This requirement is not met as evidenced by; based on interviews and observations. Staff did not keep the facility free of rodents, this poses a potential health and safety risk to the children.
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By POC due date 8/28/2024, facility will submit a plan on how they will insure center is free of rodents.
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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: 08/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3