434413020-5-31-2023-07-CC-JSEA-CSTT8Z-20230615143109

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434413020
Report Date: 05/31/2023
Date Signed: 05/31/2023 09:04:41 AM

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
03/15/2023 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230315081906

FACILITY NAME:	SUNNYMONT-WESTSIDE PARENT CO-OP NURSERY SCHOOL		FACILITY NUMBER:	434413020
ADMINISTRATOR:	JUSTINE SAFFIR		FACILITY TYPE:	850
ADDRESS:	15040 UNION AVENUE		TELEPHONE:	(408) 371-7646
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY:	30	CENSUS: 0	DATE:	05/31/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Prudence Kolano		TIME COMPLETED:	09:15 AM

ALLEGATION(S):

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Staff roughly handled day care child causing bruising

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Mel Matos & Ashley Lopez conducted an unannounced follow-up complaint investigation and met with Prudence Kolano, Director. Purpose of today's follow up complaint investigation: deliver investigation findings. The investigation of the complaint allegation listed above was conducted by LPAs Mel Matos & Ashley Lopez. Based on interviews, record reviews, observations, and evidence gathered during the investigation process, it is concluded that although the allegation noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. The allegation is UNSUBSTANTIATED.

A Notice of Site Visit was provided to Director, Prudence Kolano, 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: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

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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