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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430710075
Report Date: 03/16/2023
Date Signed: 03/16/2023 12:45:24 PM

Substantiated


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
03/15/2023 and conducted by Evaluator Pietro Hernandez
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230315112820
FACILITY NAME:PRIMARY PLUS - HIBISCUS (INFANTS)FACILITY NUMBER:
430710075
ADMINISTRATOR:MERCEDES MENDOZAFACILITY TYPE:
830
ADDRESS:801 HIBISCUS LANETELEPHONE:
(408) 985-5998
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY:106CENSUS: 31DATE:
03/16/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Renee TorresTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff do not provide a comfortable room temperature for day care children.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Pete Hernandez conducted an initial site visit to the child care facility to investigate the complaint allegation listed above that involved an alleged violation. LPA met with Director Renee Torres, and explained to her the purpose of the inspection.

On 3/16/2023 LPA Hernandez conducted interview with the Director. Room temperatures were taken, records and photos were obtained. LPA observed temperatures in rooms 2,4,and 6, rooms the childen occupied, did not meet minimum of 68 degrees F required accordance with the California Code of Regulations, Title 22.

Based on LPA’s observations, and interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on the 9099D. Licensee/Director was informed that failure to correct the deficiencies may result in civil penalties.. Exit interview was conducted, where this report was reviewed with Director Renee Torres.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED NEAR OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
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 2
Control Number 07-CC-20230315112820
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PRIMARY PLUS - HIBISCUS (INFANTS)
FACILITY NUMBER: 430710075
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2023
Section Cited
CCR
101239(a)(1)
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101239(a)(1) Fixtures, Furniture, Equipment and Supplies: A comfortable temperature for children shall be maintained at all times. The licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F [..] and a maximum of 85 degrees F (30 degrees C). This requirement is not met as evidenced by:
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By The POC Date: The Licensee shall submit a plan of correction to CCLD that will ensure The licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F [..] and a maximum of 85 degrees F (30 degrees).
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LPA observed temperatures in rooms 2, 4, and 6. The rooms the children occupied did not meet minimum of 68 degrees F required accordance with the California Code of 68 degrees F. This poses a potential risk to the children.
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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.
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2