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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430709457
Report Date: 07/07/2026
Date Signed: 07/07/2026 11:01:17 AM

Substantiated


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
05/04/2026 and conducted by Evaluator Marilou Monico
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20260504103547
FACILITY NAME:GOOD SAMARITAN EDUCATION & ENRICHMENT PROGRAMSFACILITY NUMBER:
430709457
ADMINISTRATOR:CORIA, GUADALUPEFACILITY TYPE:
850
ADDRESS:19624 HOMESTEAD ROADTELEPHONE:
(408) 996-8290
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:71CENSUS: 10DATE:
07/07/2026
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Guadalupe Coria & Stacey BelgerTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Day care child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
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On July 7, 2026, Licensing Program Analyst (LPA), Marilou Monico, made an unannounced complaint inspection to deliver investigation findings for the above allegation. LPA met with Site Director, Guadalupe Coria, and Assistant Director, Stacey Belger. LPA toured the facility and a census was taken.

During the course of this investigation, LPA interviewed staff, parents, and Behavioral Therapist. Photos, medical report, and other relevant documents were obtained.

It was reported that a child (C1) sustained bruising on the arms. C1 was picked up from the center on April 10, 2026 at approximately 5:40 PM. The marks were observed by C1’s parent at home at approximately 9:50 PM the same day. C1 was brought to the doctor on April 27, 2026.

Continuation on next page:
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
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 5
Control Number 07-CC-20260504103547
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: GOOD SAMARITAN EDUCATION & ENRICHMENT PROGRAMS
FACILITY NUMBER: 430709457
VISIT DATE: 07/07/2026
NARRATIVE
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Interviews with staff indicated that no marks were observed on C1 while in care. Staff, the Behavioral Therapist, and the parents all denied witnessing any incidents involving staff harming children. However, Staff (S1) was observed relocating children to other activity area by holding them by both arms. The observed staff handling is consistent with the type and location of C1's injuries. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Exit interview conducted and report was reviewed with Site Director, Guadalupe Coria. Appeal rights were provided.

Per Title 22, Division 12, of the California Code of Regulations, the following Type B deficiency is being cited: (see next page).

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 07-CC-20260504103547
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: GOOD SAMARITAN EDUCATION & ENRICHMENT PROGRAMS
FACILITY NUMBER: 430709457
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/07/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/14/2026
Section Cited
CCR
101223(a)(1)
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Personal Rights - (a)The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement is not met as evidenced by:
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Site Director states that she will provide additional training to staff regarding appropriate ways to safely move children to different areas. Site Director states that she will submit a written plan along with attendance sheet and training agenda by 07/14/26.
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Staff (S1) used an improper technique while relocating children to a different activity area, which resulted in child (C1) sustaining bruising on the arms. This poses a potential risk to the health, safety, and personal rights to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
05/04/2026 and conducted by Evaluator Marilou Monico
COMPLAINT CONTROL NUMBER: 07-CC-20260504103547

FACILITY NAME:GOOD SAMARITAN EDUCATION & ENRICHMENT PROGRAMSFACILITY NUMBER:
430709457
ADMINISTRATOR:CORIA, GUADALUPEFACILITY TYPE:
850
ADDRESS:19624 HOMESTEAD ROADTELEPHONE:
(408) 996-8290
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:71CENSUS: 10DATE:
07/07/2026
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Guadalupe Coria & Stacey BelgerTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff do not ensure that day care child's hygiene needs are met while in care.
Staff do not ensure that day care child is adequately fed while in care.
INVESTIGATION FINDINGS:
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On July 7, 2026, Licensing Program Analyst (LPA), Marilou Monico, made an unannounced complaint inspection to deliver investigation findings for the above allegation. LPA met with Site Director, Guadalupe Coria, and Assistant Director, Stacey Belger. LPA toured the facility and a census was taken.

During the course of this investigation, LPA interviewed staff, parents, and Behavioral Therapist. Photos, medical report, and other relevant documents were obtained.

Based on interviews, it was reported that children typically stand during diaper changes and bend forward when being wiped. Staff stated that they ensure children are thoroughly cleaned during diaper changes. Additionally, other parents reported that they have not observed their children returning home with inadequately cleaned diaper areas.

Continuation on next page:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 07-CC-20260504103547
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: GOOD SAMARITAN EDUCATION & ENRICHMENT PROGRAMS
FACILITY NUMBER: 430709457
VISIT DATE: 07/07/2026
NARRATIVE
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C1’s parent reported that they requested the daycare provide C1 with cereal instead of French toast. The Site Director did not immediately communicate this request to C1’s teacher; however, C1 was offered other available food, and this appeared to be an isolated incident. Interviews with staff indicated that if a child refuses to eat, the child is provided with other alternative food options.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.


----------------------------------------------------------END OF REPORT-----------------------------------------------------
SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5