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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434410825
Report Date: 04/22/2026
Date Signed: 04/24/2026 09:09:22 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
04/13/2026 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20260413142757
FACILITY NAME:EMPIRE MONTESSORI PRESCHOOLFACILITY NUMBER:
434410825
ADMINISTRATOR:JENNIFER KARENSOUVONGFACILITY TYPE:
850
ADDRESS:499 NORTH 11TH STREETTELEPHONE:
(408) 295-5900
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:44CENSUS: 23DATE:
04/22/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jennifer KarnsouvongTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
1. Staff pinched day care child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/22/26, Licensing Program Analyst(LPA)Anna Morales conducted an announced subsequent complaint investigation to deliver the findings for the above allegation. LPA was met by Director Jennifer Karnsouvong. LPA toured the facility and observed three staff supervising 23 preschool aged children(during nap time). LPA observed that the facility was operating in compliance with teacher to children ratio requirement.
It was alleged that Staff pinched day care child. Interviews were conducted with staff, parents and children. Staff interviewed denied the allegation and stated that they have never observed any of the staff pinch a child(ren). Children stated that they have never been pinched by the staff and like their teachers. Parents stated that their child(ren) have never disclosed that staff pinched them nor observed staff pinch a child. Parents did disclose that they have concerns with how staff handle redirecting their child(ren).

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with Director Jennifer Karnsouvong. Appeal Rights provided. Notice of Site Visit was issued an must be posted for 30 days in a visible location.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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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