434415355-5-1-2024-07-CC-JSEA-D7PVRT-20240731164027

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434415355
Report Date: 05/01/2024
Date Signed: 05/01/2024 08:24:06 PM

Substantiated

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
04/26/2024 and conducted by Evaluator Samantha Yip

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240426112219

FACILITY NAME:	AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE		FACILITY NUMBER:	434415355
ADMINISTRATOR:	JUHEE DO		FACILITY TYPE:	850
ADDRESS:	1229 NAGLEE AVENUE		TELEPHONE:	(408) 472-8288
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95126
CAPACITY:	31	CENSUS: 22	DATE:	05/01/2024
		UNANNOUNCED	TIME BEGAN:	08:31 AM
MET WITH:	Sooho Lee and Juhee Do		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is out of ratio

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced complaint investigation for the above allegation. LPA met with Licensee Sooho Lee and explained the reason for the inspection. Director Juhee Do arrived shortly after. Upon arrival, LPA observed that there were five children with S-1. There were no other staff present at the time.

During today's inspection, LPA conducted observation. LPA interviewed staff and third party. LPA also reviewed sign in/out and staff files. Based on the information obtained, the above allegation is found to be SUBSTANTIATED, meaning the preponderance of the evidence standard has been met.
--------------CONTINUES ON 9099 DATED 5/01/2024 PAGE 2------------------

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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 4

Control Number 07-CC-20240426112219

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE	FACILITY NUMBER: 434415355
	VISIT DATE: 05/01/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

--------------CONTINUATION OF 9099 DATED 05/01/2024 PAGE 1------------

Based on interview and record review, S-1 has not complete any courses. LPA spoke to the college that S-1 enrolled in courses. College stated that there is no proof of completion of courses. Director understands that S-1 does not qualify to be a teacher. LPA discussed with Director teacher-child ratio and that if S-1 is with a fully qualified teacher that they would only be able to care for up to 15 children.

LPA observed there were children from 729 Morse Street (#434415356) being dropped off at this location. Facility has a waiver to commingle children in the afternoon from 3PM to 6PM. Director understands that they need to seize commingling facilities due to facilities not having a granted waiver to commingle in the morning. Facility will submit an updated waiver to commingle children to Licensing with the times that they are requesting children to commingle.

As a result of this investigation, a Type A citation was issued. Exit interview conducted and report was reviewed with Director Juhee Do. A notice of site visit has been issued and must remain posted for 30 days.

LPA Samantha Yip informed Director Juhee Do that this report dated 05/01/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the Director to provide a copy of this licensing report dated 05/01/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 07-CC-20240426112219

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: AGAPE CHRISTIAN PRESCHOOL OF SAN JOSE	FACILITY NUMBER: 434415355
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/02/2024 Section Cited CCR 101216.3(a)	1 2 3 4 5 6 7	Teacher-Child Ratio. There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	By POC 05/02/2024, Director will submit written plan on how she will ensure that facility is within ratio; along with staffing schedule.
	8 9 10 11 12 13 14	Based on observation, interviews, and record review, S-1 does not have record of completion of any courses. S-1 was alone with children upon arrival. This poses an immediate health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4