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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434409738
Report Date: 08/31/2020
Date Signed: 09/03/2020 03:35:09 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
06/26/2020 and conducted by Evaluator Tuoc Doan
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20200626170104
FACILITY NAME:WEBSTER, KARENFACILITY NUMBER:
434409738
ADMINISTRATOR:WEBSTER, KARENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 360-9978
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY:14CENSUS: 4DATE:
08/31/2020
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Karen WebsterTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Licensee is sleeping while children are in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuoc Doan conducted a Subsequent Tele-investigation via video call with Licensee Karen Webster. LPA informed her of the purpose of the video call and the finding for the allegation above was delivered to the Licensee.

LPA explained to Licensee that due to the COVID-19 pandemic and "Shelter in Place" Order, this LIC9099 Complaint Investigation Report was generated at the Licensing Office and will be emailed to Licensee. Licensee's reply to the email will serve as acknowledgement that the report was received.

Complainant alleges that Licensee is sleeping while children are in care. Information was obtained from interviews with Licensee and other parties involved. Records pertaining to the case, which included the Facility Roster were also obtained and reviewed. Based on the information obtained, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. Therefore, the allegation is found to be UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2020
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-20200626170104
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: WEBSTER, KAREN
FACILITY NUMBER: 434409738
VISIT DATE: 08/31/2020
NARRATIVE
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 Exit interview was conducted, where this report was reviewed with Licensee over the video call.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc DoanTELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2