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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434414441
Report Date: 04/09/2024
Date Signed: 04/09/2024 09:49:26 AM

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
03/20/2024 and conducted by Evaluator Jessica Bongardt
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240320150625
FACILITY NAME:EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PSFACILITY NUMBER:
434414441
ADMINISTRATOR:CORTEZ, ELVIRAFACILITY TYPE:
850
ADDRESS:1399 SANTEE DRIVETELEPHONE:
(408) 573-4823
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY:181CENSUS: 96DATE:
04/09/2024
UNANNOUNCEDTIME BEGAN:
08:57 AM
MET WITH:Josephine DalitTIME COMPLETED:
10:05 AM
ALLEGATION(S):
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Staff discarded daycare child's food while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Bongardt conducted a subsequent complaint visit and met with Josephine Dalit, Site Director today. The purpose of LPA’s visit was to deliver investigation findings.

On March 27, 2024, and April 09, 2024, LPA conducted unannounced inspections of the facility. During the course of the investigation, staff interviews were conducted. Facility records were reviewed. Sign in sheets for the children were obtained.

It was reported to the department that a child’s food was discarded while the child was still eating during the time she was in care. It was determined by interviews and an incident report that was submitted by the facility that the incident did occur.

Based on investigation, file review, and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 07-CC-20240320150625
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: EDUCARE CALIFORNIA AT SILICON VALLEY HEADSTART/PS
FACILITY NUMBER: 434414441
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/03/2024
Section Cited
CCR
101223(a)(3)
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(a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from... other actions of a punitive nature including but not limited to: interference with functions of daily living including eating...
This requirement was not met as evidence by:
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Training with staff will be conducted and submitted to LPA by the plan of correction date.
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Based on interviews and the self reported incident the licensee did not comply with the section cited above by a teacher taking food away from a child which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2