430703695-4-18-2024-07-CC-GKUN-D5QNM5-20240529103431

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430703695
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:49:12 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
03/13/2024 and conducted by Evaluator Sheena Chin

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240313121213

FACILITY NAME:	SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	430703695
ADMINISTRATOR:	ANN-MARIE LEMMERMAN		FACILITY TYPE:	850
ADDRESS:	1945 TERILYN AVENUE		TELEPHONE:	(408) 259-4796
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	176	CENSUS: 87	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lurvin Magana Calles		TIME COMPLETED:	11:00 PM

ALLEGATION(S):

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9

Staff did not properly report an unusual incident.
Staff threatened children in care.

INVESTIGATION FINDINGS:

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On 4/18/24 around 9:30am Licensing Program Analyst (LPA) Sheena Chin conducted an unannounced complaint inspections and met with the director, Lurvin Magana-Calles, today. LPA explained the director that the purpose of today's visit was to continue investigations and deliver the investigation finding for the above allegation.

During investigations, LPA interviewed staff, and reviewed files regarding the incident on 8/8/23 and 3/11/24. The center had followed the regulations to report incidents. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Exit interview was conducted and this report was reviewed and discussed with director, Lurvin Magaa-Calles.
Notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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