434410396-9-2-2020-07-CC-MSEA-BT5UCE-20200904152749

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434410396
Report Date: 09/02/2020
Date Signed: 09/02/2020 01:37:37 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
04/23/2020 and conducted by Evaluator Janet Tse

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20200423140028

FACILITY NAME:	ESTRADA-GIRON, ADELA		FACILITY NUMBER:	434410396
ADMINISTRATOR:	EDELA EG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 229-0480
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95111
CAPACITY:	14	CENSUS: 8	DATE:	09/02/2020
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Adela Estrada-Giron		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Licensee yells at daycare children.
Licensee threatens children.
Licensee speaks to daycare children in an inappropriate manner.
Licensee uses inappropriate forms of discipline.
Licensee slapped child.

INVESTIGATION FINDINGS:

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Due to COVID-19, LPA Janet Tse conducted a tele-inspection via Facetime with licensee Adela Estrada-Giron to deliver findings for the above allegations. LPA explained the nature of today's tele-inspection to Licensee. LPA observed eight children with Licensee and her husband Margarito Chamu in the home today.

LPA previously conducted interviews and reviewed files. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiency was cited. Notice of site visit was issued and must be posted for 30 days.

Due to COVID 19, a copy of this Licensing report with LPA's signature alone will be emailed to Licensee; and in lieu of Licensee's signature, a read receipt of the email will serve as acknowledgement of receipt of this Licensing report by Licensee.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020

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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