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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416514
Report Date: 04/07/2023
Date Signed: 04/07/2023 10:04:16 AM

Document Has Been Signed on 04/07/2023 10:04 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: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: DATE:
04/07/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:JUAN LIUTIME COMPLETED:
10:10 AM
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Licensing Program Manager (LPM), Gladys Kuizon and Licensing Program Analyst (LPA), Oscar Huang met with Licensee, Juan Liu 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 citations, dated on 03/07/2023 under section 102416.5(d)(1) Staffing Ratio and Capacity: The capacity specified on the license shall be the maximum number of twelve children, no more than four of whom may be infants, and section 102370(d) Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility obtain California Criminal Record Clearance. During a complaint investigation LPA observed that the Licensee is caring for 3 infants & 12 preschool children and a staff without criminal record clearance on 03/07/2023.



The Plan of Correction (POC) for Staffing Ratio and Capacity was submitted on 03/08/2023 on site during the complaint inspection. A POC inspection was conducted on 03/17/2023. The ratio & capacity & the staff criminal record clearance were in compliance during the POC inspection.

LPM, Gladys Kuizon explained the informal meeting and the administrative process. Licensee, Juan Liu 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, Juan Liu during today’s meeting.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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, JUAN
FACILITY NUMBER: 434416514
VISIT DATE: 04/07/2023
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The report was discussed and verbally translated into Chinese during the exit interview with licensee, Juan Liu, and licensee 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: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
LIC809 (FAS) - (06/04)
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