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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415080
Report Date: 02/28/2025
Date Signed: 02/28/2025 02:54:04 PM

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
01/22/2025 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250122083642
FACILITY NAME:SELIMOVIC, BELMAFACILITY NUMBER:
434415080
ADMINISTRATOR:SELIMOVIC, BELMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 603-8911
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY:14CENSUS: 10DATE:
02/28/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Belma SelimovicTIME COMPLETED:
03:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee not meeting day care child(rens) needs while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Mandeep Kaur met with Licensee, Belma Selimovic, for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. LPA conducted observations, reviewed staff files, reviewed random children files, interviewed licensee, staff and random parents during the investigation. LPA toured the inside and outside of the facility during investigation.

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

Exit interview conducted and report was reviewed with Licensee, Belma Selimovic.

Notice of site visit issued and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
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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