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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416687
Report Date: 07/14/2022
Date Signed: 07/15/2022 08:07:05 AM

Substantiated


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
05/20/2022 and conducted by Evaluator Samantha Yip
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220520091052
FACILITY NAME:HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOLFACILITY NUMBER:
434416687
ADMINISTRATOR:JESSICA WATTSFACILITY TYPE:
850
ADDRESS:8455 WREN AVENUETELEPHONE:
(408) 413-2111
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:65CENSUS: 38DATE:
07/14/2022
UNANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Jessica WattsTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Facility playground is hazardous
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced subsequent complaint investigation. LPA met with Site Director Jessica Watts and explained the reason for the inspection.

During the course of the inspection, LPA interviewed staff and children. LPA also inspected the outdoor activity area on 05/26/2022 and 07/14/2022. LPA also reviewed documents, such as ouch report and parent handbook. Based on the information obtained, the above allegation is found to be SUBSTANTIATED, meaning the “preponderance of the evidence” standard has been met.

---------------------------continues on 9099 dated 07/14/2022 page 2----------------------------------
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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 5
Control Number 07-CC-20220520091052
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 434416687
VISIT DATE: 07/14/2022
NARRATIVE
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--------------------------continuation of 9099 dated 07/14/2022 page 1------------------------------

LPA observed on 05/26/2022 that there was a wooden beam that went across the pergola, which was about 3 feet above the ground. LPA observed children bending over or squatting down in order to go under the beam and staff having to remind children to go around the pergola. There are bikes on the the other side of the pergola for the children to play with. There was an incident on 05/19/2022 where a child bumped their face on the wooden beam, which caused there to be a red mark on the child's nose.

The facility had their contractor move the wooden beam higher on 05/27/2022. The wooden beam is currently about 6 feet off the ground.

As a result of this investigation, a Type B citation has been cited. Exit interview conducted and report was reviewed with the Director, Jessica Watts. 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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 07-CC-20220520091052
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PRESCHOOL
FACILITY NUMBER: 434416687
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2022
Section Cited
CCR
101238(a)
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Building and Grounds. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
This requirement is not met as evident by:
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Defiency has been corrected. On 05/27/2022, facility had their contractor move the wooden beam higher. It is currently about 6 feet off the ground.
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Based on observation and record reviews, facility had a wooden beam that went across the pergola that was about 3 feet off the ground. LPA observed that children had to bend down or squat down to go under. There was an incident where a child bumped into it and obtained a red mark on their face, which 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: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5