434414738-5-18-2021-07-CC-SKNT-C38LQQ-20210521085752

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414738
Report Date: 05/18/2021
Date Signed: 05/18/2021 04:34:58 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
05/10/2021 and conducted by Evaluator Pietro Hernandez

COMPLAINT CONTROL NUMBER: 07-CC-20210510110511

FACILITY NAME:	BUTTERFLIES ACADEMY, INC		FACILITY NUMBER:	434414738
ADMINISTRATOR:	AZARCHEHR, FARINAZ		FACILITY TYPE:	850
ADDRESS:	14103 SARATOGA AVE.		TELEPHONE:	(408) 867-3772
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY:	30	CENSUS: 18	DATE:	05/18/2021
		UNANNOUNCED	TIME BEGAN:	01:16 PM
MET WITH:	Farinaz Azarcherhr		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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1) Staff are not wearing PPE

2) Staff are not practicing social distancing

INVESTIGATION FINDINGS:

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On 5/18/2021: Licensing Program Analyst (LPA) Pietro Hernandez conducted an unannounced Subsequent Complaint Investigation via Video Conference at the Facility. LPA spoke with Farinaz Azarcherhr and discussed the finding for the above allegations. This was also delivered by email return receipt to the Facility during the visit.

During the course of the investigation, LPA inspected the Child Care Center, reviewed records, and conducted interviews with the Director, Teachers, helpers, and parents. LPA Hernandez determined that all 4 alligations are unsubstanciated.

Continued on page 2 of LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021

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-20210510110511

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: BUTTERFLIES ACADEMY, INC	FACILITY NUMBER: 434414738
	VISIT DATE: 05/18/2021

NARRATIVE

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Continuation of Page 1 LIC9099
Allegations:

1) Staff are not wearing masks. LPA Hernandez observed that the facility Staff is trying to encourage face coverings to be worn by the preschoolers contestant with the California Pubiic Health Department guideline dated 5/3/2021. Staff are required to wear masks. It is unclear however how consistently the facility is encouraging the wearing of face coverings prior to 5/3/2021 and after. There seemed to be confusion regarding the correct guideline and how much encouraging has been used to get the children to observe wearing of face coverings. Therefore; this is unsubstantiated.

2) Staff are not practicing social distancing. During the investigation the LPA learned that the facility was following the guidelines for social distancing as best as possible. LPA did get conflicting testimony though out the course of his investigation. LPA could not prove or disprove that this guideline was consistently observed by the facility. Therefore; this is unsubstantiated.

Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A deficiency is not being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. An exit interview was conducted by Video Conference, and Plan of Corrections was reviewed and developed with the licensee. A copy of this report and appeals rights were discussed and provided to the Licensee by email, Farinaz Azarcherhr, as proof this form has been confirmed received by "return receipt" of these documents due to Covid-19 shelter in place orders.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 334-2151
LICENSING EVALUATOR NAME: Pietro Hernandez	TELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021

LIC9099 (FAS) - (06/04)

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