434412709-11-12-2020-07-CC-SKNT-BVAQDU-20201112110517

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434412709
Report Date: 11/10/2020
Date Signed: 11/12/2020 10:41:23 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
07/21/2020 and conducted by Evaluator Tuoc Doan

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20200721094959

FACILITY NAME:	BRIGHT STARZ		FACILITY NUMBER:	434412709
ADMINISTRATOR:	MARIA NAVARRO		FACILITY TYPE:	850
ADDRESS:	810 WASHINGTON STREET		TELEPHONE:	(408) 564-0863
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95050
CAPACITY:	24	CENSUS: 14	DATE:	11/10/2020
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Navarro		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Licensee did not follow Admission Agreement.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tuoc Doan conducted a subsequent Tele-investigation via video call with Licensee Maria Navarro. LPA informed Licensee of the purpose of the video call and the finding for the allegation above was delivered to the facility. LPA explained to Licensee that due to the COVID-19 pandemic and "Shelter in Place" Order, this LIC9099 Complaint Investigation Report was generated at the Licensing Office and will be emailed to Licensee. Licensee's reply to the email will serve as acknowledgement that the report was received.

Complainant alleges that Licensee charged complainant $300 more than the tuition amount written in their contract. The investigation provided sufficient evidence and corroborating information to establish that the Licensee did not follow the Admission Agreement that Licensee entered into with Complainant and Choices for Children, a child care subsidy program. Licensee did charge Complainant $300 more than the amount agreed upon in their contract/admission agreement.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

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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Control Number 07-CC-20200721094959

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: BRIGHT STARZ	FACILITY NUMBER: 434412709
	VISIT DATE: 11/10/2020

NARRATIVE

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Based on the information obtained, the preponderance of evidence standard has been met. Therefore, the allegation that Licensee did not follow Admission Agreement is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on the next page.

Exit interview was conducted, where this report, the citation, plan of correction, and appeal rights were reviewed with Licensee over the video call.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

LIC9099 (FAS) - (06/04)

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Control Number 07-CC-20200721094959

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: BRIGHT STARZ	FACILITY NUMBER: 434412709
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/10/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/10/2020 Section Cited CCR 101219(f)	1 2 3 4 5 6 7	ADMISSION AGREEMENTS. The licensee shall comply with all terms and conditions set forth in the admission agreement. This requirement is not met as evidenced by: Based on LPA’s review of the Admission Agreement, Certificate for Child Care Services, and Payment records, Licensee did	1 2 3 4 5 6 7	This deficiency has been corrected. Licensee refunded $300 to C-1's parent on 07/16/2020. Licensee stated that she understands that she shall comply with all terms and conditions set forth in the admission agreement. Furthermore,
	8 9 10 11 12 13 14	not follow the Admission Agreement for C-1 when Licensee charged C-1’s parent $300 more than the tuition amount in their contract/admission agreement.	8 9 10 11 12 13 14	Licensee stated that she understands that any modifications to the original admission agreement shall be made whenever circumstances covered in the agreement change, and shall be dated and signed by the licensee and the child's parent.
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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: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

LIC9099 (FAS) - (06/04)

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