434417275-7-15-2024-07-CC-BDEL-D89L7V-20240818083059

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434417275
Report Date: 07/15/2024
Date Signed: 07/15/2024 12:13:46 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
05/21/2024 and conducted by Evaluator Melvin S Matos

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20240521120213

FACILITY NAME:	BUILDING KIDZ OF SUNNYVALE IN LAKEWOOD VILLAGE		FACILITY NUMBER:	434417275
ADMINISTRATOR:	WILSON KO		FACILITY TYPE:	850
ADDRESS:	878 LAKEWOOD DRIVE		TELEPHONE:	(408) 737-7022
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94089
CAPACITY:	38	CENSUS: 4	DATE:	07/15/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Wilson Ko		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff did not prevent day care children from having access to a hazardous item

Staff are not providing a comfortable environment for day care children

Staff are not adequately supervising day care children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mel Matos met with Wilson Ko, Licensee Representative/Director, for an unannounced follow up complaint investigation to deliver investigation findings. Based on interviews, observations, record reviews, and evidence gathered during the investigation process, it is concluded that although the allegations noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Licensee Representative/Director, Wilson Ko. No deficiencies issued. A notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

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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