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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416482
Report Date: 09/29/2025
Date Signed: 09/30/2025 03:35:39 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
07/22/2025 and conducted by Evaluator Syhshyan Yu
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250722104050
FACILITY NAME:LIU, QIANYIFACILITY NUMBER:
434416482
ADMINISTRATOR:QIANYI LIUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 334-8640
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 12DATE:
09/29/2025
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Jie LiuTIME COMPLETED:
10:50 AM
ALLEGATION(S):
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Day care provider is not at the day care for the required amount of time
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shine Yu conducted an unannounced Complaint investigation to deliver the findings. Licensee was absence, LPA met with facility representative, Jie Liu. Present during investigation were 2 staff and 12 children, including 2 under 2 years old.

On 7/25/2025, LPA conducted an initial Complaint investigation and reviewed supporting documentation. Licensee was present and LPA interviewed licensee, staff 1(S1), and toured facility.
On 9/16/2025 and 9/26/2025, LPA conducted interviews with parents. LPA reached out to 6 parents and 3 granted LPA an interview. Based on interviews, 1 parent had heard or observed the licensee was not at day care during operation hours.
On 9/29/2025, LPA observed licensee was abscent for appointment during inspection. Licensee called LPA and stated the appointment would take more than 20 percent of child care home operation hours.

(continue on page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
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 3
Control Number 07-CC-20250722104050
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: LIU, QIANYI
FACILITY NUMBER: 434416482
VISIT DATE: 09/29/2025
NARRATIVE
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Throughout the investigation process, it was found the allegation is SUBSTANTIATED; based on interviews, observations, and information gathered by LPA. A finding that is SUBSTANTIATED means the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

As a result, one type B deficiency was cited on the following page and copy of Appeal Rights was given.

Exit interview was conducted and reviewed in Mandarin with the facility representative, Jie Liu.

A Notice of Site Visit was issued and must remain POSTED for 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20250722104050
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: LIU, QIANYI
FACILITY NUMBER: 434416482
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/07/2025
Section Cited
CCR
102417(a)
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102417 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. ... Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
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Licensee will submit a plan of correction to LPA before the POC due date.
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This requirement is not met as evidenced by: Based on LPAs observations and interviews, Licensee is temporary absences from child care home and exceed 20 percent of the hours that the facility is providing care per day. This poses a potential risk to the health, safety, and personal rights to 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.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3