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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413697
Report Date: 07/12/2023
Date Signed: 07/12/2023 03:14:57 PM

Document Has Been Signed on 07/12/2023 03:14 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:RAINBOW CHILDHOOD DEVELOPMENT CENTERFACILITY NUMBER:
434413697
ADMINISTRATOR:HELEN QIUFACILITY TYPE:
830
ADDRESS:227 SOUTH MAIN STREETTELEPHONE:
(408) 781-8428
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/12/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Helen QiuTIME COMPLETED:
03:30 PM
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On Wednesday, July 12, 2023 at 1:55 pm, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Case Management Visit - Deficiencies. LPA met with the Director Hele Qiu and explained the nature of the visit. Present on this visit were 3 staff and 9 infants.

The deficiencies, initially cited during a visit on 05/03/2023, have been cleared as of today Wednesday, July 12, 2023.


No deficiencies were observed at the time of the visit.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director Helen Qiu.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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