434410778-4-23-2021-07-CC-MSEA-C2CTFL-20210423144140

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434410778
Report Date: 04/22/2021
Date Signed: 04/23/2021 10:51:42 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
02/17/2021 and conducted by Evaluator Fermin Campos-Jaramillo

COMPLAINT CONTROL NUMBER: 07-CC-20210217103859

FACILITY NAME:	EARLY LEARNING PRESCHOOL		FACILITY NUMBER:	434410778
ADMINISTRATOR:	YASHEVA CAESAR		FACILITY TYPE:	850
ADDRESS:	1133 PIEDMONT ROAD		TELEPHONE:	(408) 937-1545
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95132
CAPACITY:	49	CENSUS: 3	DATE:	04/22/2021
		ANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:			TIME COMPLETED:	02:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained an injury while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an announced complaint tele-visit via WhatsApp (due to COVID-19). LPA met with Nita Vaidya, acting Site Director, with the purpose of delivering findings on the investigation of the above allegation. LPA observed there were 3 children in care, and taking a nap.
Based on LPA observations, on a police report, and on the interviews which were conducted with staff and with the children's parents; the incident did occurred, and the child resulted with a minor injury while playing on the merry go round. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. However there was not lack of supervision involved which could lead to issue a deficiency.
A NOTICE OF SITE VISIT WAS ISSUED, AND EMAILED AND MUST BE POSTED NEAR THE ENTRANCE TO THE FACILITY, AND REMAIN POSTED FOR 30 DAYS.
LPA requested that Licensee, respond to the email, acknowledging have received the report and the notice to LPA within 24 hours.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2021

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 1