430701361-5-9-2023-07-CC-DSTN-CSDMLS-20230601094246

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430701361
Report Date: 05/09/2023
Date Signed: 05/09/2023 01:55:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
04/03/2023 and conducted by Evaluator Kassandra Medrano

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230403140458

FACILITY NAME:	ACTION DAY NURSERY		FACILITY NUMBER:	430701361
ADMINISTRATOR:	JILL MILLER		FACILITY TYPE:	850
ADDRESS:	2146 LINCOLN AVENUE		TELEPHONE:	(408) 266-8952
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY:	154	CENSUS: 145	DATE:	05/09/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Brittany Bostic & Jamie Ferguson		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff does not ensure the facility is kept free from pests

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kassandra Medrano, conducted a subsequent site visit to the facility to deliver investigation findings. LPA met with Regional Director, Jamie Ferguson, Director, Brittany Bostic explained to her the purpose of the visit.

LPA Medrano conducted interviews, toured the facility and obtained copies of pertinent information. Throughout the investigation process, it was found the allegation listed above is unsubstantiated. Based on information obtained; there is not enough evidence to prove that the above allegation occurred. Due to the above information, the allegations are UNSUBSTANTIATED. A finding that is unsubstantiated means although the allegation may have happened or is valid , the preponderance of evidence does not prove it.

NOTICE OF SITE VISIT WAS ISSUED AND SHALL BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kassandra Medrano	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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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