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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430703695
Report Date: 01/08/2025
Date Signed: 01/08/2025 11:54:34 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
10/29/2024 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20241029142231
FACILITY NAME:SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
430703695
ADMINISTRATOR:LURVIN MAGANA-CALLESFACILITY TYPE:
850
ADDRESS:1945 TERILYN AVENUETELEPHONE:
(408) 259-4796
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:176CENSUS: 68DATE:
01/08/2025
UNANNOUNCEDTIME BEGAN:
08:17 AM
MET WITH:Richard GehrelsTIME COMPLETED:
09:08 AM
ALLEGATION(S):
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Child was injured while in care due to lack of care and supervision.
Staff are not maintaining soft cushioning for the play area.
Staff are not meeting toddlers diapering needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mandeep Kaur and Licensing Program Manager(LPM), Belinda Devall met with Assistant Director, Richard Gehrels, and explained purpose of visit- to deliver complaint investigation findings. LPA conducted complaint investigation comprising of interviews, observations, records review, and evidence gathered. LPA and LPM toured the outdoor areas of the facility with Assistant Director during today's investigation.

Based on interviews, observations, records review, and evidence gathered during the investigation process, the child (C1) was injured while in care, howerver, it was not due to lack of care and supervision. There is no high climbing structure observed in toddler play area that requires cushioned material to absorve the fall, however, Director, Lurvin Magana-Calles self-admitted that there was an uneven pavement that was fixed previously.


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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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-20241029142231
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: SJB - SAN JUAN BAUTISTA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 430703695
VISIT DATE: 01/08/2025
NARRATIVE
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Based on interviews, observations, records review, and evidence gathered during the investigation process, it is concluded that although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. The allegations are UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Assistant Director, Richard Gehrels.

Notice of site visit issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2