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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416344
Report Date: 01/17/2023
Date Signed: 01/17/2023 10:26:44 AM

Document Has Been Signed on 01/17/2023 10:26 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MA, JIEFACILITY NUMBER:
434416344
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
01/17/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Jie MaTIME COMPLETED:
10:40 AM
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Licensing Program Manager (LPM), Gladys Kuizon and Licensing Program Analyst (LPA), Oscar Huang met with Licensee, Jie Ma & her husband, Zijun (Leo) Chen at the San Jose Regional Office today for a scheduled Informal Meeting. The purpose of today’s meeting is to discuss the Licensee’s compliance history and ability to follow Title 22 Regulations.

This Informal Meeting is a direct result the following Type A citation, dated on 11/21/2022 under section 102416.5(b)(2) Staffing Ratio and Capacity: The capacity specified on the license shall be the maximum number of six children, no more than three of whom may be infants. During a complaint investigation LPA observed that the Licensee is caring for four infants & one preschool children on 11/21/2022.



The Plan of Correction (POC) for Staffing Ratio and Capacity was submitted on 11/22/2022 on site during the complaint inspection. A POC inspection was conducted on 12/06/2022. The ratio & capacity was in compliance during the POC inspection.

LPM, Gladys Kuizon explained the informal meeting and the administrative process. Licensee, Jie Ma was advised that continued non-compliance with Title 22 Regulations could result in their license being referred to CCL's legal department for review and possible action against the license. Assembly Bill 633 (Child Care Parent Notification Requirements) and Acknowledgement of Receipt of Licensing Reports (LIC9224) was also explained and provided to Licensee, Jie Ma during today’s meeting.

Licensee, Jie Ma understood that this department will increase monitoring of the facility for the next twelve months.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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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