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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416300
Report Date: 03/05/2025
Date Signed: 03/06/2025 10:53:10 AM

Document Has Been Signed on 03/06/2025 10:53 AM - 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:WANG, WEIFACILITY NUMBER:
434416300
ADMINISTRATOR/
DIRECTOR:		WEI WANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 378-7178
CITY:SAN JOSESTATE: CAZIP CODE:
95133
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/05/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:20 PM
MET WITH:Wei WangTIME VISIT/
INSPECTION COMPLETED:
04:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kate Huang and Licensing Program Manager (LPM) Gladys Kuizon conducted an unannounced Case Management visit today. LPA and LPM met with Licensee Wang, Wei.

During today's visit, LPM and LPA reviewed records and interviewed staff. The licensee did not have a current children's roster. Licensee completed the children's roster during inspection. Children's dates of birth were inaccurate when verified against the children's records.

A ratio of 2 staff and 10 children were observed. 6 of 10 children present were under the age of 2.

As a result of todays inspection, one type A deficiency and one type B deficiency were cited, see LIC809-D.

LPA Kate Huang informed licensee that this report dated on 03/05/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Kate Huang informed the licensee to provide a copy of this licensing report dated on 03/05/2025 that document one Type A citation 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.

Exit interview conducted with licensee, Wei Wang, in Mandarin. A copy of this report was provided along with licensee's appeal rights.

Notice of Site visit provided.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 03/06/2025 10:53 AM - It Cannot Be Edited


Created By: Linke Huang On 03/05/2025 at 03:57 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: WANG, WEI
FACILITY NUMBER: 434416300

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/06/2025
Section Cited
CCR
102416.5(d)(1)

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(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,..., shall be...(1) Twelve children, no more than four of whom may be infants...This requirement was not met as evidenced by:
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Licensee to submit written plan of correction by POC due date.
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During today's inspection, 6 out of 10 children present were infants under 2 years old. Based on interview with licensee, she understands she can only have a maximum of 4 infants per her approved license capacity. This poses an immediate risk to the health and safety of children in care.
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Type B
03/14/2025
Section Cited
CCR102417(g)(8)

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102417 Operation of a Family Child Care Home (g)(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement was not met as evidenced by:
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Licensee to submit written plan of correction by POC due date.
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During today's inspection, licensee did not have a current children's roster and completed one during the inspection. Children's dates of birth on roster were inaccurate. This poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gladys Kuizon
LICENSING EVALUATOR NAME:Linke Huang
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2025


LIC809 (FAS) - (06/04)
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