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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444408744
Report Date: 09/22/2023
Date Signed: 09/22/2023 05:16:07 PM

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
09/19/2023 and conducted by Evaluator Samantha Yip
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230919140144
FACILITY NAME:HAPPY DAYS CHILDREN'S LEARNING CENTERFACILITY NUMBER:
444408744
ADMINISTRATOR:ANDREA MARCFACILITY TYPE:
850
ADDRESS:191B HARVEY WEST BOULEVARDTELEPHONE:
(831) 469-9358
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:69CENSUS: 35DATE:
09/22/2023
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Andrea MarcTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility failed to report incident to Licensing
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced complaint investigation. LPA met with staff, Christina and explained the reason for the inspection. Director Andrea Marc arrived at 12:08PM.

During the course of this investigation, LPA conducted interviews with staff and reviewed staff files. 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 809 dated 09/22/2023 page 2---------------------
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
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 4
Control Number 07-CC-20230919140144
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: HAPPY DAYS CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 444408744
VISIT DATE: 09/22/2023
NARRATIVE
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--------------continuation of 9099 dated 09/22/2023 page 1--------------------

Based on interview and document review, there was incident involving a staff, which was not reported to Licensing. LPA discussed with Director the reporting requirements.

As a result of this inspection, a Type B deficiency was issued. Exit interview conducted and report was reviewed with Director Andrea Marc.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20230919140144
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: HAPPY DAYS CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 444408744
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/29/2023
Section Cited
CCR
101212(d)
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Reporting Requirements. Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
This requirement is not met as evidenced by:
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By 09/29/2023, Director will submit acknowledgement that she understands the reporting requirements.
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Based on interview and record reviews, there was an incident involving a staff, which was not reported to Licensing. 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: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4