434415424-10-9-2025-07-CC-LHUG-DMAVGS-20251009162601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415424
Report Date: 10/09/2025
Date Signed: 10/09/2025 04:26:10 PM

Document Has Been Signed on 10/09/2025 04:26 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	ORGANIZATION OF SPECIAL NEEDS FAMILIES		FACILITY NUMBER:	434415424
ADMINISTRATOR/ DIRECTOR:	ALEJANDRA GOMEZ		FACILITY TYPE:	840
ADDRESS:	511 S BASCOM AVE. (FRONT BLDG)		TELEPHONE:	(408) 996-0850
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY: 6	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/09/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Lihuei Yau		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

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Licensing Program Analysts (LPAs) Kate Huang and Farida Raja conducted an announced case management inspection in response to a request to increase the facility’s capacity from 6 to 15 school-age children, ranging from kindergarten to 18 years old. LPAs meet with Lihuei Yau - Licensee representative and informed her purpose of inspection. During this visit, Lihuei Yau stated that she will be the new director and will submit the required director documents soon. There are 4 classroom and 2 playgrounds in the facility.

A fire clearance approving a capacity of 15 children was granted on 08/29/2025. However, the licensee representative needs to provide an updated facility sketch reflecting the off-limits kitchen area, which children will pass through to access the playground. A barricade and safety gate need to be installed in the kitchen to allow children to safely pass through to the playground, as the kitchen is an off-limits area.

The center will operate Monday–Friday 2:00 PM - 7:00 PM. LPAs toured and measured the indoor (Rooms 1, 2, 3, 4) and outdoor areas (Playgrounds 1 and 2) of the facility during today's inspection. No children were present during today's inspection.

Indoor Classrooms measurements are:

Indoor measurements contain a total of 679.17 square feet, which will accommodate 19 children.

Outdoor measurements are:

Outdoor total measurements contain a total of 1030.81 square feet, which will accommodate 13 children.

Indoor and outdoor space utilized by children was inspected today. There are 5 tables, 15 chairs including bar stools and benches, 21 hooks, 1 toilet, 1 sink available for children to use in the indoor classrooms. The classrooms were observed to be clean, safe, sanitary and in good repair. All rooms have age-appropriate materials, toys, and equipment for children.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: ORGANIZATION OF SPECIAL NEEDS FAMILIES	FACILITY NUMBER: 434415424
	VISIT DATE: 10/09/2025

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Furniture and equipment were observed to be maintained in good condition, free of sharp, loose or pointed parts. LPAs observed trash cans with tight fitting lids for the disposal of solid waste throughout the Facility. Restrooms for children and staff to use were observed to be in good operating condition. There is a kitchen inside the facility; however, the licensee representative stated that it will be off-limits to children and that no food will be prepared for them. Children will bring their own snacks.

The facility has adequate ventilation, including central air conditioning and heating. LPAs observed a fully charged fire extinguisher, as well as functioning smoke and carbon monoxide detectors.

LPAs toured the outdoor areas. Two outdoor playgrounds were inspected and observed to be fenced and free of hazards. Currently, there is no play equipment or toys set up in the outdoor playgrounds. The licensee representative showed LPAs the outdoor toys children will use, which are stored in the garage. The licensee representative also stated that a canopy, currently stored in the storage room, will be used for outdoor activities.

There were no bodies of water observed. LPA informed the licensee representative that a waiver request will need to be submitted for the outdoor area as current square footage can only accommodate 13 children. The licensee representative will submit a waiver request soon.

The upstairs areas are used for storage, and no individuals reside there. Licensee representative stated that Room 4 is isolation area to separate sick children.

Licensee has not yet decided whether the facility’s faucets will be used for drinking purposes. LPA provided the licensee representative with the Lead Testing PIN (21-21.1-CCP).

As a result of today’s inspection, no deficiencies were cited.

LPAs advised that a license for 15 children will be granted pending manager review/approval and submission of the following items:
1. A waiver request for outdoor areas (needs to be approved)

2. An updated facility sketch reflecting the off-limits kitchen area

3. Photos showing that a barricade and safety gate have been installed in the kitchen to allow children to safely pass through to the playground; and

4. Lead test results must be provided if the facility’s faucets will be used for drinking or food preparation purposes. Otherwise, the licensee must provide a written statement indicating that outside water will be used for drinking and food preparation.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025

LIC809 (FAS) - (06/04)

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