434414297-11-8-2023-07-CC-JSEA-CY52A5-20231201161257

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414297
Report Date: 11/08/2023
Date Signed: 11/08/2023 03:00:59 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
09/18/2023 and conducted by Evaluator Samantha Yip

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230918154444

FACILITY NAME:	JOHNSON, CHRISTINA		FACILITY NUMBER:	434414297
ADMINISTRATOR:	JOHNSON, CHRISTINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 413-9272
CITY:	GILROY	STATE: CA	ZIP CODE:	95020
CAPACITY:	14	CENSUS: 5	DATE:	11/08/2023
		UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Christina Johnson		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Provider's conduct poses a risk to day care children in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced complaint investigation. LPA met with Licensee Christina Johnson and explained the reason the inspection. Present during today's inspection were Licensee and five children, whom one was infant age.

During the course of this inspection, LPA conducted interviews with Licensee, assistant, and third party. Based on the information obtained, the above allegation is found to be UNSUBSTANTIATED, meaning although, the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies were issued as a result of this inspection. Exit interview conducted and report was reviewed with Licensee Christina Johnson. A notice of site visit has been issued and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

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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