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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434400285
Report Date: 11/06/2019
Date Signed: 11/06/2019 01:26:36 PM



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
08/19/2019 and conducted by Evaluator Shannel Reed
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20190819161407
FACILITY NAME:SAN JOSE DAY NURSERY INFANT/TODDLER PROGRAMFACILITY NUMBER:
434400285
ADMINISTRATOR:ELENA JOLLYFACILITY TYPE:
830
ADDRESS:33 N. 8TH STREETTELEPHONE:
(408) 288-9667
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:24CENSUS: 19DATE:
11/06/2019
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Elena JollyTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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9
Child has been bitten several times, due to lack of supervision.
Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shannel Reed arrived at the center today to conduct an unannounced complaint investigation at the center today to deliver investigation findings regarding the allegations that that a child (C-1) has been bitten several times, due to lack of supervision and that the facility is operating out of ratio. LPA met with Executive Director, Elena Jolly, and informed her of the purpose of today’s inspection. LPA observed 19 infants with 7 teaching staff (4 teacher and 3 aides). LPA reviewed the complaint allegations with Ms. Jolly. During the course of the investigation, LPA conducted interviews with the Center Director, teachers, and parents regarding the allegations.
Based on the information received regarding the allegation that a child (C-1) has been bitten several times, due to lack of supervision, the child, C-1, was bitten while teachers were present, and the staff did observe the incidents and document the incidents on “Minor Injury/ Incident Reports”. The center has also been working with the teachers and children regarding biting by shadowing the child being bitten as well as the child that is biting. The center has followed the detailed Bite policy that is in place as well as implemented different strategies to track various biting incidents in the infant program.
REPORT CONTINUED ON THE FOLLOWING PAGE (REPORT DATED 11/06/19):
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019
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-20190819161407
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: SAN JOSE DAY NURSERY INFANT/TODDLER PROGRAM
FACILITY NUMBER: 434400285
VISIT DATE: 11/06/2019
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (REPORT DATED 11/06/19):
Regarding the second allegation that the center is operating out of ratio, LPA interviewed parents and reviewed the daily count sheets and the infant teacher time sheets. LPA verified that the Center has sufficient staffing throughout the day. Therefore, based on the information received during this investigation LPA concludes that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Shannel ReedTELEPHONE: (408) 489-9484
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2