434412171-7-25-2024-07-CC-JSEA-D8YS2V-20240910133010

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434412171
Report Date: 07/25/2024
Date Signed: 07/25/2024 03:20:48 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
06/12/2024 and conducted by Evaluator Marilou Monico

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240612132752

FACILITY NAME:	KIDDIE ACADEMY OF CUPERTINO		FACILITY NUMBER:	434412171
ADMINISTRATOR:	JACALNE, MARIA SOCORRO		FACILITY TYPE:	850
ADDRESS:	19875 STEVENS CREEK BLVD.		TELEPHONE:	(408) 517-0454
CITY:	CUPERTINO	STATE: CA	ZIP CODE:	95014
CAPACITY:	119	CENSUS: 85	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Annabelle Catolico		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Daycare child sustained unexplained bruising

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Marilou Monico, met with Assistant Director, Annabelle Catolico, and conducted a follow-up complaint inspection and to deliver findings.

Based on interviews, observations, record reviews, and evidence gathered during the investigation process, it is concluded that although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

Exit interview conducted and the report was reviewed with the Assistant Director, Annabelle Catolico.

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

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Marilou Monico	TELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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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