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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415832
Report Date: 12/09/2024
Date Signed: 12/09/2024 04:50:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
10/02/2024 and conducted by Evaluator Farida Raja
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20241002102319
FACILITY NAME:SJB-ROULEAU CHILD DEVELOPMENT CENTERFACILITY NUMBER:
434415832
ADMINISTRATOR:NATIVIDAD DE LA ROSAFACILITY TYPE:
850
ADDRESS:1875 MONROVIA DRIVETELEPHONE:
(408) 573-4713
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:16CENSUS: 9DATE:
12/09/2024
UNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Lisa Thompson and Iyare IsiborTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Staff grabbed child's arm forcefully
INVESTIGATION FINDINGS:
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On 12/09/2024 at 9:12am, Licensing Program Analyst (LPA), Farida Raja conducted an unannounced complaint visit to deliver investigation findings for the above allegation. LPA met with Master Teacher, Lisa Thompson and explained the purpose of today's visit. Staff stated that Director, Iyare Isibor has stepped out and will be back soon. Director arrived at 9:45am.

During today's inspection, LPA toured the facility and observed ratios. LPA observed a total of 5 children and 5 teachers in classrooms 1A and 1B.

During the course of this investigation, LPA interviewed staff including director and parents and reviewed relevant records.

Continued on Page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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 4
Control Number 07-CC-20241002102319
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SJB-ROULEAU CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 434415832
VISIT DATE: 12/09/2024
NARRATIVE
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Based on staff interviews, staff stated that they did not observe any staff handle child in a rough manner in the form of grabbing or pushing the child. Staff stated that child was carried and placed on nap mat. Staff stated that they did not observe any staff push or force the child to sleep or lay down.

Based on parent interviews, parents stated that they have not observed any behaviors from staff that are of concern.

Based on interviews and evidence gathered at this time, it is concluded that although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

Exit interview conducted with Director, Iyare Isibor and Associate Program Director, Maria Velazquez.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Farida Raja
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4