434414541-10-4-2024-07-CC-BDEL-DB7ABT-20241119230515

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414541
Report Date: 10/04/2024
Date Signed: 10/04/2024 10:21:56 AM

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
07/10/2024 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240710100230

FACILITY NAME:	TULIP KIDS ACADEMY		FACILITY NUMBER:	434414541
ADMINISTRATOR:	PUSHPALATHA VENNA		FACILITY TYPE:	830
ADDRESS:	1279 LAWRENCE STATION		TELEPHONE:	(669) 255-0540
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94089
CAPACITY:	28	CENSUS: 13	DATE:	10/04/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Yesenia Velazquez		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff used unusual forms of punishment on children in care
Staff speak inappropriately to children in care
Staff did not prevent child from biting another child in care
Child sustained an injury while in care
Staff do not ensure reporting requirements are followed
Child was left in unsafe napping equipment
Staff does not ensure soap dispenser are properly maintained
Staff do not ensure adequate supervision is provided to children in care
Facility is out of ratio

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Mel Matos met with Yesenia Velazquez, Director, 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 allegations are thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Director, Yesenia Velazquez. 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: 10/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024

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 1