434416349-12-8-2023-07-CC-GKUN-CYJVKB-20231215153003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434416349
Report Date: 12/08/2023
Date Signed: 12/08/2023 03:31:59 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
10/09/2023 and conducted by Evaluator Yangcheng Huang

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20231009163204

FACILITY NAME:	WANG, CHI MEI		FACILITY NUMBER:	434416349
ADMINISTRATOR:	WANG, CHI MEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 933-8762
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY:	14	CENSUS: 2	DATE:	12/08/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Chi Mei Wang		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Licensee does not provide clean bedding for children in care.
Licensee is serving expired food to children in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Oscar Huang, conducted an unannounced subsequent complaining visit to the Facility today. LPA Huang met with Licensee, Chi Mei Wang and explained the nature of today's visit to her.

Based on interviewed with staff, and LPA's own observations, the allegations listed above could not be proved or disproved. LPA concludes that although the allegations may have happened or are valid, there were not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiency was cited. The investigation report was discussed and verbally translated into Chinese during the exit interview with Licensee, Chi Mei Wang.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023

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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