430703788-7-12-2023-07-CC-GKUN-CTXTL3-20230721144853

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430703788
Report Date: 07/12/2023
Date Signed: 07/12/2023 12:35:14 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
06/08/2023 and conducted by Evaluator Anna Morales

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230608092851

FACILITY NAME:	BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL		FACILITY NUMBER:	430703788
ADMINISTRATOR:	STEPHANIE MASCIOCCHI		FACILITY TYPE:	850
ADDRESS:	1940 TOWNSEND AVE.,RMS25,26&27		TELEPHONE:	(408) 423-1321
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY:	112	CENSUS: 35	DATE:	07/12/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Silvia Bejarano/ Whitney Lukanc		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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1. Staff inappropriately handled child in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anna Morales and Licensing Program Manager (LPM) Gladys Kuizon made a subsequent unannounced site visit to deliver the findings for the above allegation. LPA and LPM met with Site Supervisor Silvia Bejarano and Program Specialist Whitney Lukanc and explained the purpose of the visit.

On 6/8/2023, the Department received the above allegation against the facility. LPA Morales interviewed the Director, staff and other potential witnesses. Facility records including Unusual Incident Report, police reports and photos were obtained and reviewed.

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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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Control Number 07-CC-20230608092851

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL	FACILITY NUMBER: 430703788
	VISIT DATE: 07/12/2023

NARRATIVE

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The investigation revealed that on 6/2/23, Teacher (S1) stated that at approximately at 1:30pm, left Classroom Number 25 for a one hour lunch break during nap time. Teacher (S2) came to relieve Teacher (S1) and was left alone to supervise the children in Classroom 25. Teacher (S1) stated that child (C1) was still awake on the cot prior to leaving. According to Teacher (S1), S1 returned to the classroom approximately at 2:30pm, and observed C1 looking at photos on Teacher ( S2) cell phone. S1 stated that S2 was sitting on a chair next to C1.

On the evening of 6/2/23, bruises were found on child (C1) right arm and underneath C1's armpit. C1 stated that S2 pushed C1 down onto the cot during nap time because C1 did not want to lay down. Photos of these injuries were taken and reviewed.

LPA reviewed a police report prepared on 6/26/23 by the Santa Clara Police Department stating that on 6/2/23, C1 right arm obtained a small (less than 1") red/brown circular bruise, about 3 inches below the crease of the armpit and general bruising in the right armpit. According to C1, an incident occurred at the facility during nap time with S2 that likely caused the injury.

Interviews with staff, including S2, confirmed that S2 was the only staff member with C1 during nap time on 06/02/2023.

Based on evidence obtained during the Department's investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

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SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 07-CC-20230608092851

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIARWOOD CHILDREN'S CENTER/STATE PRESCHOOL	FACILITY NUMBER: 430703788
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/12/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/12/2023 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	Personal Rights(a)(3) Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The Department served an Immediate Order of Exclusion to Director and Annette Baker today. Failure to comply with the Order of Exclusion shall be grounds for discipline, including suspension or revocation of the license. LPM and LPA observed Annette Baker leave the facility.
	8 9 10 11 12 13 14	Based on staff interviews, photos, and police record review, C1's bruises found on the right arm was likely caused by physical abuse that was sustained while in care. This posed an immediate risk to C1's health and safety.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

LIC9099 (FAS) - (06/04)

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