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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430701361
Report Date: 01/17/2024
Date Signed: 01/18/2024 09:01:42 AM

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
12/14/2023 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20231214093405
FACILITY NAME:ACTION DAY NURSERYFACILITY NUMBER:
430701361
ADMINISTRATOR:BATE, STEPHANIEFACILITY TYPE:
850
ADDRESS:2146 LINCOLN AVENUETELEPHONE:
(408) 266-8952
CITY:SAN JOSESTATE: CAZIP CODE:
95125
CAPACITY:154CENSUS: 108DATE:
01/17/2024
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Lucy NunezTIME COMPLETED:
04:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Staff did not follow a daycare child's dietary needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA)Anna Morales conducted an unannounced subsequent complaint visit investigation today and met with Program Director, Lucy Nunez. The purpose of today's visit was to deliver the investigation finding for the above allegation.

On 12/18/23, LPA's Anna Morales and Jessica Bongardt conducted an initial complaint investigation. Interviews were conducted with staff, reviewed children's roster and C1's records. On 1/4/24, LPA Morales interviewed Staff and reviewed centrally stored medication.

-continue on LIC9099C-
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
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 2
Control Number 07-CC-20231214093405
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ACTION DAY NURSERY
FACILITY NUMBER: 430701361
VISIT DATE: 01/17/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Staff stated that the Children's allergies are listed on the children's roster which is located in each of the classrooms. Staff stated that the food they serve the children for special events is store bought, always inaccessible to children's reach until the event begins and parents are present. Staff interviewed did not observe allergic reaction to child(C1) in care during one of the preschool's special events.

Based on evidence gathered, including record/document reviews, and interviews completed for the complaint investigation, 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 the alleged violations did or did not occur. The allegation is thus UNSUBSTANTIATED.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2