430709448-12-15-2020-07-CC-SKNT-BWCNKY-20201216093243

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430709448
Report Date: 12/15/2020
Date Signed: 12/15/2020 10:58:37 AM

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
11/03/2020 and conducted by Evaluator Pietro Hernandez

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20201103130949

FACILITY NAME:	PRIMARY PLUS - INFANTS		FACILITY NUMBER:	430709448
ADMINISTRATOR:	LOPEZ, LORENA		FACILITY TYPE:	830
ADDRESS:	18720 BUCKNALL ROAD		TELEPHONE:	(408) 370-0350
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY:	83	CENSUS: 22	DATE:	12/15/2020
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Lorena Lopez		TIME COMPLETED:	01:46 PM

ALLEGATION(S):

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1) Playground structures are in disrepair.

2) Playground structures are not sanitized.

INVESTIGATION FINDINGS:

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On 12/15/2020: Licensing Program Analyst (LPA) Pietro Hernandez conducted an unannounced Subsequent Complaint Investigation via Video Conference at the Facility. LPA spoke with Lorena Lopez and discussed the finding for the above allegations. This was also delivered by email return receipt to the Facility during the visit.

During the course of the investigation, LPA inspected the Child Care Center, reviewed records, and conducted interviews with the Director, Teachers, helpers. LPA Hernandez determined that both 2 allegations are unsubstantiated.

Continued on page 2 of LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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-20201103130949

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: PRIMARY PLUS - INFANTS	FACILITY NUMBER: 430709448
	VISIT DATE: 12/15/2020

NARRATIVE

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Continuation of Page 1 LIC9099
1) Facility is in disrepair.
During the course of the LPA, Hernandez's investigation, interviews and on site observations, the LPA did not observe any playground equipment in disrepair. There was no way to prove or disprove that is was ever in disrepair prior to receiving the complaint or the LPA performing the on site inspection. The LPA was provided copies of work orders for the maintenance and inspection of the playground for any necessary repairs. The child care center had requested regular proactive maintenance prior to the complaint.

2) Playground structures are not sanitized.
During the LPA's investigation and interviews no evidence was observed that would affirm that the playground structures were routinely sanitized or not routinely sanitized. All of the people interviewed said that this is done routinely but there is no documentation to verify that it occurs. LPA was unable to observe all day but did observe the sanitizing did occur. The facility uses a hand pumped sprayer and wipes down the playground equipment. Since formal documentation is not done, the LPA cannot say the work is performed the way the staff says it does.

Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A deficiency is not being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted by Video Conference was reviewed with the licensee. A copy of this report was discussed and provided to the Licensee by email, Lorena Lopez, as proof this form has been confirmed received by "return receipt" of these documents due to Covid-19 shelter in place orders.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

LIC9099 (FAS) - (06/04)

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