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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434408755
Report Date: 05/27/2026
Date Signed: 05/27/2026 06:00:23 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
05/21/2026 and conducted by Evaluator Andy Yang
COMPLAINT CONTROL NUMBER: 07-CC-20260521162710
FACILITY NAME:ACTION DAY PRIMARY PLUSFACILITY NUMBER:
434408755
ADMINISTRATOR:FARRAH DERLAFACILITY TYPE:
850
ADDRESS:5845 ALLEN AVENUETELEPHONE:
(408) 629-6020
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:254CENSUS: 149DATE:
05/27/2026
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Ortencia GuzmanTIME COMPLETED:
06:10 PM
ALLEGATION(S):
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Other - Staff did not maintain facility at a comfortable temperature for children in care
INVESTIGATION FINDINGS:
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On 5/27/2026, Licensing Program Analyst (LPA) Andy Yang conducted an unannounced complaint investigation. LPA met with Acting Director, Ortencia "MIssy" Guzman and discussed the complaint allegation with them and to deliver the findings. Present for today’s investigation were Acting Director, Regional Director, (15) staff, and (148) children. LPA toured the indoor areas of the facility with Acting Director.

LPA conducted interviews with the Acting Director, Regional Director, and staff. LPA conducted observations and interacted with parents and children in care. LPA received documents.

Allegation stated that staff did not maintain facility at comfortable temperature for children in care. During today's investigation, LPA had observed comfortable temperature in the classrooms through out the day, which was within required title 22 regulations. Based on interview with the Acting Director the temperature is operating during hours of operation from 7:00am to 6:00pm. At 5:43pm, LPA observed the classroom temperature for room K4 was at 73 degrees Fahrenheit.
***Continue Page 2***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
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-20260521162710
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: ACTION DAY PRIMARY PLUS
FACILITY NUMBER: 434408755
VISIT DATE: 05/27/2026
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 Acting Director, Ortencia Guzman.
SUPERVISORS NAME: Mireya Flores
LICENSING EVALUATOR NAME: Andy Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2