434415422-4-13-2023-07-CC-DSTN-CRHVGH-20230504162528

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434415422
Report Date: 04/13/2023
Date Signed: 04/13/2023 11:20:09 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
02/28/2023 and conducted by Evaluator Kassandra Medrano

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230228083809

FACILITY NAME:	EMPIRE MONTESSORI PRESCHOOL		FACILITY NUMBER:	434415422
ADMINISTRATOR:	MARIA S & SHIMEI Y		FACILITY TYPE:	850
ADDRESS:	585 WEST ALMA AVENUE		TELEPHONE:	(408) 505-7562
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY:	105	CENSUS: 65	DATE:	04/13/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Maria Jacalne		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff yelled/screamed at teachers in an innaporpriate manner while children were present
Facility did not report unusual incidents to licensing
facilitiy is not following menus posted
Child was terminated without notice
Facility did not maintain childrens records

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kassandra Medrano, conducted a subsequent site visit to the facility to deliver investigation findings. LPA met with Licensee, Shi Mei Yang, Director, Maria Jacalne and Joyce Brown, Regional Manager, and explained to her the purpose of the visit.

LPA Medrano conducted interviews, toured the facility and obtained copies of pertinent information. Throughout the investigation process, it was found the allegations listed above were unsubstantiated. Based on information obtained; there is not enough evidence to prove hat the above allegations occurred. Due to the above information, the allegations are UNSUBSTANTIATED. A finding that is unsubstantiated means although the allegation may have happened or is valid , the preponderance of evidence does not prove it.

NOTICE OF SITE VISIT WAS ISSUED AND SHALL BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Kassandra Medrano	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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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