<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415154
Report Date: 05/02/2025
Date Signed: 05/02/2025 04:00:10 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
02/12/2025 and conducted by Evaluator Syhshyan Yu
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250212155803
FACILITY NAME:DOBROVOLSKAYA, LIUDMILAFACILITY NUMBER:
434415154
ADMINISTRATOR:DOBROVOLSKAYA, LIUDMILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 650-8060
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY:14CENSUS: 11DATE:
05/02/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Liudmila DobrovolskayaTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Neglect/Lack of Supervision - Child sustained unexplained injuries while in care
Physical abuse - Teacher hit child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Shine Yu conducted a subsequent complaint visit and met with staff and licensee Dobrovolskaya, Liudmila today. The purpose of LPA’s visit was to deliver investigation findings.

On 02/05/2025, Licensing Program Manager (LPM) Gladys Kuizon and LPA Shine arrived unannounced at the facility and toured the facility, reviewed records, observed children/teacher interaction and interviewed licensee and staff. On 02/13/2025, another unannounced visit at the facility was conducted to observe children/teacher interaction and conducted additional interview with staff. On 03/24/2025, parents were interviewed.

Based on confidential 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 are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.

Due to today's investigation, no deficiencies are cited. Exit interview conducted and report was reviewed and translated by family member with licensee Dobrovolskaya, Liudmila. NOTICE OF SITE VISIT PROVIDED AND MUST REMAIN POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Gladys KuizonTELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Syhshyan YuTELEPHONE: (408) 334-8321
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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