434408781-8-11-2021-07-CC-DSTN-C5YSVP-20210817141303

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434408781
Report Date: 08/11/2021
Date Signed: 08/11/2021 01:02:24 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/27/2021 and conducted by Evaluator Janette Cruz

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20210527100824

FACILITY NAME:	KIDDIE ACADEMY OF SAN JOSE		FACILITY NUMBER:	434408781
ADMINISTRATOR:	MARIE NUNEZ		FACILITY TYPE:	850
ADDRESS:	521 WEST CAPITOL EXPRESSWAY		TELEPHONE:	(408) 978-1500
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	98	CENSUS: 32	DATE:	08/11/2021
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Marie Nunez		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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9

Staff hit a daycare child while in care.

Staff inappropriately pushed a daycare child while in care.

Staff placed a daycare child in an inappropriate restraint.

Staff yelled at a daycare child

INVESTIGATION FINDINGS:

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2
3
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Licensing Program Analysts (LPAs)Janette Cruz and Mel Matos conducted an unannounced follow-up complaint investigation and met with Marie Nunez, Director. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the four allegations listed above were conducted by LPAs Cruz and Matos. Based on the available evidence including observations, record reviews and interviews completed for this 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 allegations are thus UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

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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