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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430710492
Report Date: 10/07/2022
Date Signed: 10/07/2022 01:52:58 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
07/20/2022 and conducted by Evaluator Janette Cruz
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20220720100651
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: 51DATE:
10/07/2022
UNANNOUNCEDTIME BEGAN:
12:46 PM
MET WITH:Brittany StrangeTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Facility failed to keep free of rodents
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Janette Cruz conducted an unannounced follow up complaint investigation and met with Brittany Strange, Infant Center Director. Purpose of today's follow up complaint investigation: deliver investigation findings.

During investigation it was discovered that there were presence of rodents by the kitchen area (fridge) and cubbies/storage for children’s snacks, therefore the above allegation is SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met.

A deficiency is being cited on the attached LIC 9099D form.

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


Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
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-20220720100651
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: 10/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/07/2022
Section Cited
CCR
101227(18)
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101227 Food Services
(18) All kitchen, food-preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin. This requirement was not met as evidenced by:
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On 7/29/22, Licensee submitted a written plan to keep all areas of the facility clean and free of rodents including the food preparation and storage areas. Licensee provided proof of professional pest control services conducted at the facility.
Deficiency has been cleared.
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Based on observation, interviews, and record reviews, Licensee did not comply with the section cited above. During investigation, it was discovered that there were presence of rodents by the kitchen area (fridge) and cubbies/storage for children’s snacks which posed a potential health, safety or personal rights risk to persons in care.
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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: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette CruzTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2