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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415350
Report Date: 10/15/2025
Date Signed: 10/22/2025 03:44:02 PM

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
09/11/2025 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250911140042
FACILITY NAME:NGUYEN, TRANGFACILITY NUMBER:
434415350
ADMINISTRATOR:NGUYEN, TRANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 646-1705
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:14CENSUS: 11DATE:
10/15/2025
UNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Trang NguyenTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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9
Licensee did not ensure proper supervision was provided to children in care.
Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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On 10/15/2025, Licensing Program Analyst(LPA) Mandeep Kaur met with Licensee, Trang Nguyen for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. LPA conducted observations, interviewed Licensee, staff, and attempted to interview random parents during the investigation. LPA toured indoor areas of the facility during investigation. Upon arrival, During today's investigation, LPA observed 11 children(two infants and Nine Preschool age) with licensee's one assistant(S1) inside the home.

Based on interviews, the Department concludes that licensee did not ensure proper supervision was provided to children in care. Licensee's minor assistant(S2) was left alone one day in September 2025, with children in care during a nap time for about 20 minutes. Based on observations and interviews, The Department concludes that facility is operating out of ratio. On 09/18/2025, upon arrival at 01:28PM, during investigation, LPA observed twelve(12) children(two infants and ten preschool age children) with licensee without any assistant present at the facility.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
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 7
Control Number 07-CC-20250911140042
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: NGUYEN, TRANG
FACILITY NUMBER: 434415350
VISIT DATE: 10/15/2025
NARRATIVE
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On 09/18/2025, Licensee self-admitted that during nap time, licensee is alone with the children in care by themselves since an assistant has to take lunch.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

During today's investigation, Type A deficiencies are being cited on the attached LIC 9099-D. Appeal rights were provided.

Exit interview conducted and report was reviewed with Licensee, Trang Nguyen. A notice of site visit has been issued and must remain posted for 30 days.

Assembly bill 633 was provided and discussed with Licensee. LPA Mandeep Kaur informed licensee, Trang Nguyen that this report dated 10/15/2025 documents two Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Mandeep Kaur informed the licensee, Trang Nguyen to provide a copy of this licensing report dated 10/15/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 7
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
09/11/2025 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250911140042

FACILITY NAME:NGUYEN, TRANGFACILITY NUMBER:
434415350
ADMINISTRATOR:NGUYEN, TRANGFACILITY TYPE:
810
ADDRESS:498 WASKOW DRIVETELEPHONE:
(408) 646-1705
CITY:SAN JOSESTATE: CAZIP CODE:
95123
CAPACITY:14CENSUS: 11DATE:
10/15/2025
UNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Trang NguyenTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Licensee used unusual form of punishment with child in care.

INVESTIGATION FINDINGS:
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Licensing Program Analyst(LPA) Mandeep Kaur met with Licensee, Trang Nguyen for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. LPA conducted observations, interviewed Licensee, staff and attempted to interview random parents during the investigation. LPA toured indoor areas of the facility during investigation. Upon arrival, during today's investigation, LPA observed 11 children (Two infants and nine preschool age)with Licensee's assistant(S1) inside the home. At 02:24PM, licensee's minor assistant(S2) arrived at the facility.

Based on interviews and observations, during the investigation process, it is concluded that although the allegation of licensee used unusual form of punishment with child in care, may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 07-CC-20250911140042
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: NGUYEN, TRANG
FACILITY NUMBER: 434415350
VISIT DATE: 10/15/2025
NARRATIVE
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No deficiency issued during today's investigation. Appeal right provided.

Exit interview conducted with Licensee, Trang Nguyen.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 07-CC-20250911140042
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: NGUYEN, TRANG
FACILITY NUMBER: 434415350
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/16/2025
Section Cited
CCR
102416.5(d)&(e)
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Staffing Ratio and Capacity: (d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either; (1) Twelve children, no more than four of whom may be infants;...(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).


This requirement was not met as evidenced by:
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By Plan of correction due date, 10/16/2025, Licensee will submit a written statement of understanding of Title 22 regulations requirement to be within ratio and her future plan to make sure there is always an adult assistant present with licensee if there are 12 children present while adhering to the Title 22 required regulations of the Large day care home.
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Based on interviews and observations, on 09/18/2025, upon arrival at 01:28PM, during nap time, Licensee was present with twelve children present without any assistant at day care home, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Aseembly bill 633 requirements and Acknowledgement of Reciept of Licensing Reports (LIC 9224) is discussed and provided to licensee.
Type A
10/16/2025
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home: (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

This requirement was not met as evidenced by:
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By plan of correction due date, 10/16/2025, licensee will submit a written statement of understanding of the Title 22 required regulations to supervise the children by an adult assistant while licensee adhere to stafiing and ratio requirements and if circumstances require licensee to be temporary absent from the day care home, that shall not exceed 20 percent of the hours that the facility is providing care per day.
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Based on interviews, licensee left her minor assistant(S2) alone with children in care for about 20 minutes during nap time, one day in September 2025, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Aseembly bill 633 requirements and Acknowledgement of Reciept of Licensing Reports (LIC 9224) is discussed and provided to licensee.
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: Susy Cervantes
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7