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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415769
Report Date: 06/07/2022
Date Signed: 06/07/2022 05:21:30 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
04/11/2022 and conducted by Evaluator Samantha Yip
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220411163945
FACILITY NAME:CHILDREN'S COURTYARD, THEFACILITY NUMBER:
434415769
ADMINISTRATOR:SHAYLYNN LUCASFACILITY TYPE:
830
ADDRESS:610 E DUNNE AVENUETELEPHONE:
(408) 778-1977
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:24CENSUS: 13DATE:
06/07/2022
UNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Annabelle CalasanzTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff is not meeting child's need
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced subsequent complaint inspection for the above allegation. LPA met with Director Annabelle Calasanz and explained the reason for the inspection. Present during today's inspection were 13 children and at least 5 staff.

During today's inspection, LPA conducted interview with staff, observation, and reviewed the MyPath app for staff. During the course of this investigation, LPA also conducted interviews with parents and staff and reviewed documents, such as Managing Challenging Behavior and employee handbook. Based on the information obtained, the above allegation is found to be UNSUBSTANTIATED, meaning although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

No deficiencies were cited as a result of this inspection. Exit interview conducted and report was reviewed with the Director, Annabelle Calasanz. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
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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