435202124-5-3-2024-26-AS-RMAO-D55RQT-20240510131402

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202124
Report Date: 05/03/2024
Date Signed: 05/03/2024 09:25:54 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/26/2024 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20240126142223

FACILITY NAME:	BEYOND POTENTIAL LEARNING CENTER		FACILITY NUMBER:	435202124
ADMINISTRATOR:	CARMELA MAGPAYO		FACILITY TYPE:	775
ADDRESS:	1753 SOUTH MAIN STREET		TELEPHONE:	(408) 438-0442
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	75	CENSUS:	DATE:	05/03/2024
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Program Director Melissa Ramos		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Staff physically abused client resulting in multiple bruises

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Program Director Melissa Ramos.

On January 26, 2024, the Department received a complaint alleging staff physically abused client resulting in multiple bruises.

On January 29, 2024, the Department received and reviewed an incident report submitted by the facility regarding altercation between 3 clients at the day program.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

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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Control Number 26-AS-20240126142223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: BEYOND POTENTIAL LEARNING CENTER	FACILITY NUMBER: 435202124
	VISIT DATE: 05/03/2024

NARRATIVE

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Based on investigation, Client (C1) splashed water on client’s (C2) face resulted in verbal and physical altercation. Staff S1 and S2 redirected clients away from each other from further injuries. S1 pulled S1 by his/her waist away from C2 towards the bathroom, while C2 was also being redirected by another staff (S2). While C1 was in the bathroom, another client C3 came in the restroom began punching C1 about 2-3 times herein C1 was hit at least once.

Based on interviews conducted by Local Law Enforcement and by the Department, on January 23, 2024, C1 had a behavioral episode, which includes a verbal argument with C2 and a physical altercation with C3. C1 described his/her two attackers with the same name. C1’s description of the first attacker matched the description of C3. C1 stated "S1" held C1 and allowed the other attacker to punch C1 about 25 times with a closed fist.

Based on interviews with staff (S1 to S4 ), they denied allegation of being physically abused towards C1 as result of his/her bruises.

Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegation is UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

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END OF REPORT.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

LIC9099 (FAS) - (06/04)

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