<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415238
Report Date: 10/19/2022
Date Signed: 10/27/2022 01:00:33 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/19/2022 and conducted by Evaluator James G Santos
COMPLAINT CONTROL NUMBER: 07-CC-20221019115822

FACILITY NAME:ABC PLAY SCHOOLFACILITY NUMBER:
434415238
ADMINISTRATOR:SHU CHEN PANFACILITY TYPE:
850
ADDRESS:3000 SOUTH BASCOM AVENUETELEPHONE:
(408) 645-6239
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY:35CENSUS: DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Jia Yi, Haiyan Lin and Shu Chen PanTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide care as necessary to meet the child's needs resulting in sunburn.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) James Santos conducted an unannounced subsequent complaint visit today and met with Owners, Jia Yi and Haiyan Lin and Director, Shu Chen Pan. The purpose of today's visit was to deliver the investigation finding for the above allegation.

LPA conducted interviews with staff, parents and children. Per interview with staff, they brought out the children's individual sunscreen in a container to be applied on the children during water play day. Per interview with children, the teachers help them apply sunscreen on them, and per interview with the parents, they stated that the teachers apply sunscreen to their children when needed. Also during the course of the investigation, it was noted that only one child was reported to have sunburn.

Though the child sustained sunburn, there was not enough evidence to prove that the child's needs were not met. Based on the information gathered the allegation was UNSUBSTANTIATED. A finding that is unsubstantiated means although the allegation may have happened or is valid, the preponderance of evidence does not prove it.

No deficiencies cited. Exit interview conducted and report was reviewed and a copy was provided to Director, Shu Chen Pan.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2