434410797-9-7-2022-07-CC-DSTN-CJ8P8E-20220913110521

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434410797
Report Date: 09/07/2022
Date Signed: 09/07/2022 03:30:44 PM

Unsubstantiated

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
06/20/2022 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220620093855

FACILITY NAME:	SHIR HADASH EARLY CHILDHOOD CENTER		FACILITY NUMBER:	434410797
ADMINISTRATOR:	JANET CANNON		FACILITY TYPE:	850
ADDRESS:	20 CHERRY BLOSSOM LANE		TELEPHONE:	(408) 358-1751
CITY:	LOS GATOS	STATE: CA	ZIP CODE:	95032
CAPACITY:	79	CENSUS: 28	DATE:	09/07/2022
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Lorien Aspenall		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff did not adequately supervise children in care

Child sustained an unexplained injury while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mel Matos conducted an unannounced follow-up complaint investigation and met with Assistant Director Lorien Aspenall. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the complaint allegations listed above was conducted by LPA Matos. Based on interviews, record reviews, observations, and evidence gathered during the investigation process, it is concluded that although the allegations noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. The allegation is UNSUBSTANTIATED.

A Notice of Site Visit was provided to Lorien and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

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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