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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414005060
Report Date: 03/25/2026
Date Signed: 03/25/2026 11:59:10 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2026 and conducted by Evaluator Jonathan Tse
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260129152755
FACILITY NAME:CHEN, JIALINFACILITY NUMBER:
414005060
ADMINISTRATOR:CHEN, JIALINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 533-9092
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 3DATE:
03/25/2026
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee, Jialin ChenTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Child sustained unexplained injury
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/25/2026, at approximately 11:15AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced complaint investigation visit to deliver findings for the above allegation. LPA met with Licensee, Jialin Chen, and explained the purpose of the visit.

During the course of the investigation, LPA conducted site observations, record review, and interviews with relevant parties. Licensee denied the allegation. Based on review of available evidence, there is no direct evidence to support or deny the allegation. The preponderance of evidence standard has not been met, therefore the above allegation is determined to be UNSUBSTANTIATED at this time.

No deficiencies were cited during today's visit on 3/25/2026. A notice of site visit was provided and must remain posted for 30 days. Appeal rights were provided and explained.

Exit interview conducted and report was reviewed with Licensee, Jialin Chen.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
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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