<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430710492
Report Date: 09/13/2023
Date Signed: 09/15/2023 01:00:55 AM

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
09/06/2023 and conducted by Evaluator Marilou Monico
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230906122720
FACILITY NAME:ACTION DAY NURSERYFACILITY NUMBER:
430710492
ADMINISTRATOR:STRANGE, BRITTANYFACILITY TYPE:
830
ADDRESS:3030 MOORPARK AVENUETELEPHONE:
(408) 249-0668
CITY:SAN JOSESTATE: CAZIP CODE:
95128
CAPACITY:97CENSUS: 71DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:Brittany Strange & Shivangi MehtaTIME COMPLETED:
03:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not keep facility free of insects.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Marilou Monico, conducted an unannounced complaint inspection. LPA met with Site Director, Brittany Strange, and Assistant Director, Shivangi Mehta, and discussed the above allegation. LPA toured Rooms 4, 6 & 7, interviewed staff and obtained copy of children's roster.

Based on interviews, cockroaches have been observed in the classrooms and outdoor, therefore the preponderance of evidence standard has been met and the allegation that staff did not keep facility free of insects is found to be SUBSTANTIATED.

Deficiency was cited on the following page:

Exit interview conducted and report was reviewed with Site Director, Brittany Strange.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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 3
Control Number 07-CC-20230906122720
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: ACTION DAY NURSERY
FACILITY NUMBER: 430710492
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/19/2023
Section Cited
CCR
101238(a)(1)
1
2
3
4
5
6
7
Buildings and Grounds. The licensee shall take measures to keep the center free of flies, other insects and rodents.

This requirement is not met as evidenced by: Cockroaches have been observed in the classrooms and outdoor. This poses a potential risk to the health, safety, and personal rights of children in care.
1
2
3
4
5
6
7
By POC due date, Site Director agreed to submit proof that pest control treatment had been completed and written plan detailing how staff will prevent insects/cockroaches from getting in to the classrooms.
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
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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3