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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430700197
Report Date: 06/27/2024
Date Signed: 06/27/2024 12:11:14 PM

Substantiated


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
03/11/2024 and conducted by Evaluator Samantha Yip
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240311094344
FACILITY NAME:KIDDIE KAMPUS DAY CARE CENTERFACILITY NUMBER:
430700197
ADMINISTRATOR:SUSAN COREYFACILITY TYPE:
850
ADDRESS:16330 LOS GATOS BOULEVARDTELEPHONE:
(408) 356-6776
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:171CENSUS: 95DATE:
06/27/2024
UNANNOUNCEDTIME BEGAN:
10:24 AM
MET WITH:Susan "Susie" CoreyTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff do not provide adequate care and supervision to the daycare children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced complaint investigation for the above allegation. LPA met with Director Susan "Susie" Corey and explained the reason for the inspection.

During the course of this investigation, LPA conducted observation. LPA also conducted interview with staff, children, and parents. Based on the information obtained, the above allegation is found to be SUBSTANTIATED, meaning the preponderance of the evidence standard has been met.

-------------------continues on 9099 dated 06/27/2024 page 2-----------------------
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
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-20240311094344
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: KIDDIE KAMPUS DAY CARE CENTER
FACILITY NUMBER: 430700197
VISIT DATE: 06/27/2024
NARRATIVE
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----------------continuation of 9099 dated 06/27/2024 page 1----------------------

On 05/16/2024, LPA observed outside that one of the staff had moved from the sandbox to the playhouse. There were children in the sandbox; however, due to the post in the sandbox, staff is unable to see children in the sandbox. There was no other staff positioned where they can visually supervise the sandbox.

LPA discussed with Director about ensuring that staff are positioning themselves where they can visually supervise all children at all time.

As a result of this investigation, a Type B citation was issued. Exit interview conducted and this report was reviewed with Director Susie Corey. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 07-CC-20240311094344
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: KIDDIE KAMPUS DAY CARE CENTER
FACILITY NUMBER: 430700197
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
07/08/2024
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time,... Supervision shall include visual observation.
This requirement is not met as evidenced by:
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By 07/08/2024, Director will submit written plan outlining how staff will position themselves outside to ensure children are visually
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Based on observation, LPA observed on 05/16/2024 that a staff moved from the sandbox to the playhouse. There is a post in the sandbox, which prevents staff from visually supervising children in the sandbox.
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supervised at all time. Director will also conduct training with staff and send meeting notes and staff who attended training to Licensing.
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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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
03/11/2024 and conducted by Evaluator Samantha Yip
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240311094344

FACILITY NAME:KIDDIE KAMPUS DAY CARE CENTERFACILITY NUMBER:
430700197
ADMINISTRATOR:SUSAN COREYFACILITY TYPE:
850
ADDRESS:16330 LOS GATOS BOULEVARDTELEPHONE:
(408) 356-6776
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:171CENSUS: 95DATE:
06/27/2024
UNANNOUNCEDTIME BEGAN:
10:24 AM
MET WITH:Susan "Susie" CoreyTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff do not properly report incidents involving daycare children.
Staff are yelling at daycare children.
Staff allowed pesticide to be sprayed while daycare children are present.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced complaint investigation for the above allegations. LPA met with Director Susan "Susie" Corey and explained the reason for the inspection.

During the course of this investigation, LPA conducted observation. LPA also interviewed children, staff, parents, and third party. LPA also reviewed documents, such as accident reports, and pertain information. Based on the information obtained, the above allegations are found to be UNSUBSTANTIATED, meaning, although, the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

As a result of this inspection, no deficiencies were issued. Exit interview conducted and report was reviewed with Director Susie Corey. A notice of site visit has been issued and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4