430706092-9-20-2023-07-CC-JSEA-CY4VPV-20231201153722

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430706092
Report Date: 09/20/2023
Date Signed: 09/20/2023 03:06:56 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
09/12/2023 and conducted by Evaluator Marilou Monico

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230912145845

FACILITY NAME:	CHANDLER TRIPP HEAD START		FACILITY NUMBER:	430706092
ADMINISTRATOR:	TAFOYA, VICKI		FACILITY TYPE:	850
ADDRESS:	780 THORNTON WAY		TELEPHONE:	(408) 573-4894
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY:	40	CENSUS: 14	DATE:	09/20/2023
		UNANNOUNCED	TIME BEGAN:	01:16 PM
MET WITH:	Dee Vo		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility is operating beyond the scope of its license.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marilou Monico made a complaint investigation inspection. The allegation was discussed with Site Director, Dee Vo. LPA interviewed Site Director and a staff. Based on interviews, there are two non-ambulatory children who are currently enrolled and attending the preschool program and the facility is only licensed for ambulatory children. Licensee submitted a request for 8 non-ambulatory children on 07/31/23 and is awaiting for fire clearance. The preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

As a result of this inspection, deficiency was cited on the following page:

Exit interview was conducted and report was reviewed with Site Director, Dee Vo.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

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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Control Number 07-CC-20230912145845

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: CHANDLER TRIPP HEAD START	FACILITY NUMBER: 430706092
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/20/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/22/2023 Section Cited CCR 101161(a)	1 2 3 4 5 6 7	Limitations on Capacity - A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.	1 2 3 4 5 6 7	The facility submitted an application on 07/31/23 requesting for 8 non-ambulatory children and awaiting for fire clearance. By POC due date, Site Director states that she will submit a written plan of correction to ensure that the facility operates within the scope of the license.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: there are two non-ambulatory children who are currently enrolled and attending the preschool program and the facility is only licensed for ambulatory children. This poses a potential risk to the health, safety, and personal rights to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

LIC9099 (FAS) - (06/04)

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