434409881-3-28-2022-07-CC-DSTN-CD3PLJ-20220401112445

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434409881
Report Date: 03/28/2022
Date Signed: 03/28/2022 09:45:39 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
01/10/2022 and conducted by Evaluator Janette Cruz

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220110130202

FACILITY NAME:	LINGAMPALLI, ADILAKSHMI		FACILITY NUMBER:	434409881
ADMINISTRATOR:	LINGAMPALLI, ADILAKSHMI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 532-1936
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	14	CENSUS: 1	DATE:	03/28/2022
		UNANNOUNCED	TIME BEGAN:	08:41 AM
MET WITH:	Adilakshmi Lingampalli		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Licensee pinched daycare child's ear.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Janette Cruz conducted an unannounced follow-up complaint investigation and met with Adilakshmi Lingampalli, Licensee. Purpose of today's follow up complaint investigation: deliver investigation findings. LPA observed one preschool child present in the home.

Based on the available evidence including observations, record reviews and interviews completed for this complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.

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

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

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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