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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434408999
Report Date: 12/08/2021
Date Signed: 12/08/2021 10:05:31 AM



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
10/14/2021 and conducted by Evaluator Melvin S Matos
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20211014123151
FACILITY NAME:DALAL, SHILPAFACILITY NUMBER:
434408999
ADMINISTRATOR:DALAL, SHILPAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 746-0598
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 1DATE:
12/08/2021
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Shilpa DalalTIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
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9
Licensee does not properly maintain the home

Licensee speaks inappropriately towards day care child(ren)
INVESTIGATION FINDINGS:
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2
3
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5
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7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Mel Matos conducted an unannounced follow up complaint investigation and met with Shilpa Dalal. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the complaint allegation listed in this complaint was conducted by LPA Mel Matos. Based on the available evidence, including observations of the Facility, and interviews completed for the complaint investigation, it is concluded that although the allegation noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.
A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
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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