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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444410836
Report Date: 05/11/2020
Date Signed: 05/11/2020 04:17:47 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
02/26/2020 and conducted by Evaluator Mahvash Behbood
COMPLAINT CONTROL NUMBER: 07-CC-20200226160404
FACILITY NAME:DOWNTOWN CHILDREN'S CENTERFACILITY NUMBER:
444410836
ADMINISTRATOR:CATHY LUSKFACILITY TYPE:
850
ADDRESS:120 WEEKS STREETTELEPHONE:
(831) 429-3050
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:30CENSUS: 0DATE:
05/11/2020
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Cathy LuskTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Facility staff did not comply with terms & conditions of admissions agreement.
INVESTIGATION FINDINGS:
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A Tele-Inspection was conducted by Analyst Behbood via Face Time to deliver the finding of the investigation regarding the above allegation. The allegation and the finding was discussed with Cathy Lusk, Site Director. Facility is currently closed due to Covid-19 crises.

Based on LPAs interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, 101219(b)(7) are being cited on the attached LIC. 9099D

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020
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 3
Control Number 07-CC-20200226160404
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: DOWNTOWN CHILDREN'S CENTER
FACILITY NUMBER: 444410836
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/22/2020
Section Cited
CCR
101219(b)(7)f
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Admission Agreements- The licensee shall comply with all terms and conditions set forth in the admission agreement. This requirement was not met evidence by: Current admission agreement doesn't clarify if the withdraw notice from parent must be in writing. Facility terminated a family with 2 children based on the hearsay, parent talked
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Facility to revise the admission agreement. The new admission agreement must be clear that the termination notice from either party must be in writing and it must be submitted to management.
A copy of revised admission agreement must be submitted to CCL no later than 05/22/20.
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to Office Assistant that she may take her children out of this facility since they are not adjusting. This conversation was taken as a notice and children were terminated, This is potentially dangerous to health and safety of children,
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
02/26/2020 and conducted by Evaluator Mahvash Behbood
COMPLAINT CONTROL NUMBER: 07-CC-20200226160404

FACILITY NAME:DOWNTOWN CHILDREN'S CENTERFACILITY NUMBER:
444410836
ADMINISTRATOR:CATHY LUSKFACILITY TYPE:
850
ADDRESS:120 WEEKS STREETTELEPHONE:
(831) 429-3050
CITY:SANTA CRUZSTATE: CAZIP CODE:
95060
CAPACITY:30CENSUS: 0DATE:
05/11/2020
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Cathy LuskTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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9
Facility staff did not isolate sick child.
INVESTIGATION FINDINGS:
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A Tele-Inspection was conducted by Analyst Behbood via Face Time to deliver the finding of the investigation regarding the above allegation. The allegation and the finding was discussed with Cathy.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violatio did or did not occur, therefore the allegation is UNSUBSTANTIATED
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3