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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416514
Report Date: 03/17/2023
Date Signed: 03/17/2023 02:52:44 PM

Document Has Been Signed on 03/17/2023 02:52 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LIU, JUANFACILITY NUMBER:
434416514
ADMINISTRATOR:JUAN LIUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(669) 246-2079
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
03/17/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Juan LiuTIME COMPLETED:
03:10 PM
NARRATIVE
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Licensing Program Analyst (LPA), Oscar Huang, conducted an unannounced Plan of Correction (POC) to the Facility today. LPA met with licensee Juan Liu, and explained the nature of today's visit to her. The purpose of the inspection is to review POCs for deficiencies that were cited on 03/07/2023. Present during today's inspection were licensee, a helper, 3 infants and 9 preschoolers.

The facility was issued two "Type A" deficiencies on 03/07/2023 for over capacity, and for criminal record clearance. The Plan of Correction was due on 03/10/2023.

LPA observed the Notice of Site Visit, LIC 9099 & LIC 9099-D reports which were issued 03/07/2023 were posted on wall next to the facility entrance door. Licensee submitted a plan of correction statement to CCL on 03/08/2023, prior to POC due date, LPA also observed that the Acknowledge of Receipt of Licensing Reports were signed by the parents of children in care and kept in each child's records.

LPA concludes that the the facility has completed its required plan of corrections and the deficiencies are thus cleared as of today's visit. LPA advised licensee, Juan Liu that a schedule informal meeting may be held at the San Jose Regional office to discuss the deficiencies

No deficiency was cited for this visit. A notice of site visit was given and must remain posted for 30 days. The report was discussed and verbally translated into Chinese during the exit interview with licensee, Juan Liu.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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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