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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434700102
Report Date: 06/08/2023
Date Signed: 07/07/2023 09:32:29 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/01/2022 and conducted by Evaluator Megan Vigil
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20220201072602
FACILITY NAME:BOUNDLESS CARE INCFACILITY NUMBER:
434700102
ADMINISTRATOR:ARANDA, VIVIANFACILITY TYPE:
300
ADDRESS:5988 SILVER CREEK VALLEY RDTELEPHONE:
(408) 363-8900
CITY:SAN JOSESTATE: ZIP CODE:
95138
CAPACITY:CENSUS: DATE:
06/08/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Vivian ArandaTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
HCO staff do not have a fingerprint clearance.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/8/23, Associate Governmental Program Analyst (AGPA) Megan Vigil arrived at the business office of Boundless Care INC., located at 5988 Silver Creek Valley Rd. San Jose, CA 95138.

AGPA Vigil conducted a file review and full inspection with Licensee, Vivian Aranda, no discrepancies were found. AGPA Vigil interviewed Vivian regarding the complaint details and the incident was reported properly and all proper documentation was provided.

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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
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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