434414100-12-11-2024-07-CC-BDEL-DCRRR2-20250109121424

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414100
Report Date: 12/11/2024
Date Signed: 12/11/2024 01:59:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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
09/16/2024 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240916155627

FACILITY NAME:	CREATIVE EXPLORERS		FACILITY NUMBER:	434414100
ADMINISTRATOR:	DARCY HELLUMS		FACILITY TYPE:	850
ADDRESS:	604 E. EVELYN AVE.		TELEPHONE:	(408) 685-2863
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	45	CENSUS: 19	DATE:	12/11/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Ann Doan		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff does not ensure proper supervision resulting in day care child being injured by another child

Staff are not intervening in inappropriate interactions between the day care children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mel Matos met with Ann Doan, Teacher, for an unannounced follow up complaint investigation. Purpose of today's investigation: Deliver investigation findings.

Based on interviews, observations, record reviews, 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 thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Teacher, Ann Doan. No deficiencies issued. A notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Belinda Devall	TELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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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