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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444415674
Report Date: 06/10/2021
Date Signed: 06/10/2021 01:15:48 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
04/15/2021 and conducted by Evaluator Kristal Goodell
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20210415084151
FACILITY NAME:LIFE SPRING COMMUNITY PRESCHOOL AND INFANT CAREFACILITY NUMBER:
444415674
ADMINISTRATOR:DESTINY MALONEFACILITY TYPE:
850
ADDRESS:2560 SOQUEL AVENUETELEPHONE:
(831) 477-0584
CITY:SANTA CRUZSTATE: CAZIP CODE:
95062
CAPACITY:60CENSUS: 45DATE:
06/10/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kristie DelpradoTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Lack of Supervision: Lack of supervision resulting in day care child swallowing foreign objects.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Goodell met with Assistant Director (AD) Kristie Delprado, to conduct an inspection to deliver findings for the allegation listed above. During inspection LPA toured outdoor area and preschool classrooms. LPA obtained a total census of 45 children and 8 staff. All individuals subject to criminal background review have obtained a criminal record clearance. It was alleged that a day care child swallowed foreign objects due to lack of supervision. During the investigation, LPA toured preschool classrooms and supervision. LPA obtained documents related to the complaint investigation which included the Child Roster, Staff Roster, photos of swallowed object, photos of materials used in classrooms, and photos of classroom where alleged incident occurred. LPA conducted interviews with Reporting Party, preschool parents and preschool staff. During interviews LPA learned that facility was informed of an incident that a child swallowed marbles that match the marbles used during children's sensory activity. Date of incident alleged and incident occurring at faciltiy was unknown. LPA also learned that the marbles are only used during sensory activity and were placed at the table where preschool staff supervise children. LPA learned that staff removed material from preschool classroom.
continues on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kristal Goodell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
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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Control Number 07-CC-20210415084151
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: LIFE SPRING COMMUNITY PRESCHOOL AND INFANT CARE
FACILITY NUMBER: 444415674
VISIT DATE: 06/10/2021
NARRATIVE
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Although it was alleged that incident occurred due to lack of supervision, LPA was unable to determine violation occurred due to conflicting information from interviews stating staff are present and supervising children during activities. As a result the preponderance of evidence is not met and the allegation is UNSUBSTANTIATED.

No Title 22 deficiency cited. Report was reviewed and discussed. Appeal rights issued and discussed. Notice of Site Visit was issued and must be posted for 30 days.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kristal Goodell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC9099 (FAS) - (06/04)
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