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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434412402
Report Date: 10/23/2019
Date Signed: 10/23/2019 03:22:00 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
08/08/2019 and conducted by Evaluator Mahvash Behbood
COMPLAINT CONTROL NUMBER: 07-CC-20190808142313
FACILITY NAME:SCUTTLEBUGS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434412402
ADMINISTRATOR:EUNICE KIMFACILITY TYPE:
830
ADDRESS:3291 STEVENS CREEK BLVDTELEPHONE:
(408) 564-5356
CITY:SAN JOSESTATE: CAZIP CODE:
95117
CAPACITY:38CENSUS: 28DATE:
10/23/2019
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Linda WhiteTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Facility is operating without an Administrator.
Facility staff are unqualified.
INVESTIGATION FINDINGS:
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A follow up visit was made by analyst Behbood to further investigate the above allegations and deliver the finding. Met Robert, Operational manager upon arrival. Linda White, Site Supervisor arrived shortly after. Classrooms were toured for ratio and staff. Additional staff qualification were reviewed.
Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, 101215(c) and 101216.1(c)(1) are being cited on the attached LIC. 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
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-20190808142313
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: SCUTTLEBUGS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434412402
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2019
Section Cited
CCR
101215(c)
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Administrator Qualifications and Duties - Each licensee shall make provision for continuing operation and carrying out of the administrator's responsibilities during any absence of the administrator. Qualified administrator left in June of 2019, therefore facility was operating without a qualified acting administrator until 08/12/19. This is potentially dangerous to health and safety of children.
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The citation corrected when the new qualified administrator was hired in August. Licensee agrees to follow proper procedure when administrator leaves the center for any reason and report to CCL within 10 days and designate a qualified teacher to act as an admin until a qualified administrator is hired.
Type B
10/23/2019
Section Cited
CCR
101216.1(c)(1)
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Teacher Qualifications - A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below, or shall have obtained a Child Development Assistance Permit issued by the California Commission on Teacher Credentialing. At least a two staff were not fully qualified teacher and were assigned to act as one. This is potentially dangerous to health and safety of children.
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The new administrator has hired qualified teachers and assigned staff to new classroom in order to meet qualification and ratio.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2