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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416346
Report Date: 10/24/2024
Date Signed: 10/24/2024 02:37:21 PM

Document Has Been Signed on 10/24/2024 02:37 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:ZHANG, ZHIFENGFACILITY NUMBER:
434416346
ADMINISTRATOR/
DIRECTOR:		ZHANG, ZHIFENGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 992-1037
CITY:SAN JOSESTATE: CAZIP CODE:
95118
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 11DATE:
10/24/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Zhifeng ZhangTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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Licensing Program Analysts (LPAs) Mandeep Kaur and Syhshyan "shine" Yu met with Licensee, Zhifeng Zhang, for an unannounced Plan of Correction (POC) inspection. Purpose of today's inspection: address the Plan of Correction (POC) for a "Type B" deficiency issued to the Facility on October 08, 2024. LPAs toured the indoor areas of the facility during today's inspection. Present were Licensee, Staff (S1 & S2) with 11 children.

Licensee submitted Proof of immunization records for three staff (S1,S2 & S3) as a Plan of Correction (POC) to LPAs during today's inspection addressing the violation listed below:

1) Type B deficiency: Health and Safety Section 1596.7995(a)(1)-Employees or volunteers at day care center; immunization requirements; records; exemptions: resulted from Complaint investigation on October 08, 2024. The licensee did not comply for three staff (S1, S2 and S3) which poses a potential health, safety or personal rights risk to persons in care. This presents a potential risk to the health, safety or personal rights of children in care.

It is concluded that the facility has completed the Plan of Correction for the deficiency listed above and the deficiency is thus cleared as of today, October 24, 2024.

Exit interview conducted and report was reviewed with Licensee, Zhifeng Zhang. No deficiencies issued during today's inspection. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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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