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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430757125
Report Date: 03/29/2023
Date Signed: 03/29/2023 11:40:18 AM

Unsubstantiated


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
10/25/2022 and conducted by Evaluator Joseph Macias
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20221025141834
FACILITY NAME:CRUZ, GUADALUPEFACILITY NUMBER:
430757125
ADMINISTRATOR:CRUZ, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 225-2941
CITY:SAN JOSESTATE: CAZIP CODE:
95121
CAPACITY:14CENSUS: 3DATE:
03/29/2023
UNANNOUNCEDTIME BEGAN:
09:41 AM
MET WITH:Guadalupe CruzTIME COMPLETED:
09:50 AM
ALLEGATION(S):
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Conduct Inimical
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Joe Macias conducted an unannounced complaint visit and met with the Licensee Guadalupe Cruz. The purpose of the visit is to deliver the investigation findings for the above allegation.

The investigation of the above allegation was conducted by the Community Care Licensing Division (CCLD) Investigations Bureau. Investigator Eddie Phung conducted the complaint investigation. The Investigator interviewed the Licensee and all other parties involved, reviewed facility files, as well as obtained copies of pertinent information. Based on the evidence gathered by Investigator Phung, the allegation is UNSUBSTANTIATED. An unsubstantiated finding means 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.

Exit interview conducted, and a copy of this report was provided to the Licensee Guadalupe Cruz.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE CENTER, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
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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