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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416566
Report Date: 04/06/2026
Date Signed: 04/06/2026 08:57:01 AM

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
03/16/2026 and conducted by Evaluator Andy Yang
COMPLAINT CONTROL NUMBER: 07-CC-20260316155642
FACILITY NAME:FERGUSON, MELISSAFACILITY NUMBER:
434416566
ADMINISTRATOR:MELISSA FERGUSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 569-4272
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:14CENSUS: 1DATE:
04/06/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Patricia FergusonTIME COMPLETED:
09:00 AM
ALLEGATION(S):
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Personal Rights - Staff mishandled child in care.
INVESTIGATION FINDINGS:
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On 4/06/2026, Licensing Program Analyst (LPA) Andy Yang conducted an unannounced complaint investigation. At time of arrival, LPA was greeted by staff, Patricia Ferguson. Licensee, Melissa Ferguson was not available to deliver the complaint allegation. LPA met with staff, Patricia Ferguson, to deliver the complaint allegation listed above. Present for today’s investigation were (2) staff and (1) child.

During the course of the investigation, LPA interviewed the Licensee, staff, parents, and a child. LPA conducted observations, children’s interactions, and reviewed records received.

The allegation stated that staff mishandled child in care. It was reported that Staff S1 had grabbed Child C1’s hand forcefully and had hit the child. Based on the results of the interviews, there was no indication that S1 had mishandled C1.
***Continue Page 2***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026
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-20260316155642
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: FERGUSON, MELISSA
FACILITY NUMBER: 434416566
VISIT DATE: 04/06/2026
NARRATIVE
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***Page 2***

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiency issued for this allegation. Appeal Rights provided.



A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the staff, Patricia Ferguson.
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2