434400448-3-29-2024-07-CC-GKUN-D5KW4A-20240524165710

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434400448
Report Date: 03/29/2024
Date Signed: 03/29/2024 02:50:07 PM

Substantiated

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
03/27/2024 and conducted by Evaluator Anna Morales

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240327142212

FACILITY NAME:	MARTINSON CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	434400448
ADMINISTRATOR:	LIMOS, ROSIE		FACILITY TYPE:	850
ADDRESS:	1350 HOPE DRIVE		TELEPHONE:	(408) 988-8296
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95054
CAPACITY:	70	CENSUS: 35	DATE:	03/29/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alyssia Salazar		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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1. Staff do not maintain facility sanitary

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Anna Morales conducted an initial complaint investigation and was greeted by Director Alyssia Salazar. LPA discussed with the Director the above allegation.

LPA toured the each of the classrooms and observed that in Classroom Number 4, there were multiple water spots on the ceiling panels. Director stated that on Sunday, March 25, 2024, the carpet was shampooed. Director stated that on Monday, March 26, 2024, when the school re-opened(from the weakened), staff observed that in Room #4, there were water spots on the carpet and on the ceiling.

(continue on LIC9099C)

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: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

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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Control Number 07-CC-20240327142212

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: MARTINSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434400448
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/05/2024 Section Cited CCR 101238(a)	1 2 3 4 5 6 7	Buildings and Grounds, 101238(a)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.	1 2 3 4 5 6 7	Director stated that a Licensed Contractor(roof services) conducted an inspection on 3/28/24,and plans have been implemented to address the leakage. Director stated that the carpet in Classroom Number 4 will be shampooed this weekend(3/30-3/31/24).
	8 9 10 11 12 13 14	This requirement was not met by: LPA observed water spots on the ceiling and water coming from the roof leaked into an area of the carpet which had caused a foul smell(in Room #4).	8 9 10 11 12 13 14	Director will submit a plan that will ensure that the child care center will be clean, safe, sanitary and in good repair at all times by the POC date.
	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: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC9099 (FAS) - (06/04)

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Control Number 07-CC-20240327142212

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: MARTINSON CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 434400448
	VISIT DATE: 03/29/2024

NARRATIVE

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Director stated that the leakage caused a "smell" in the Classroom and plans were implemented/conducted to ensure that the children were keep safe. (LPA did not smell any odor at the time of this investigation). Director stated that on 3/28/24, a licensed roof service conducted an inspection of the roof and steps to fix the leakage have been implemented.

Based on today's observation and on the information gathered, the preponderance of evidence standard have been met, therefore the above allegation is SUBSTANTIATED.

See LIC9099D page for deficiency cited. Exit interview conducted and copy of this report and appeal rights form provided to the Director Alyssia Salazar.

NOTICE OF SITE VISIT WAS ISSUED TO DIRECTOR AND WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Anna Morales	TELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC9099 (FAS) - (06/04)

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