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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416514
Report Date: 11/09/2023
Date Signed: 11/09/2023 10:54:48 AM

Document Has Been Signed on 11/09/2023 10:54 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: 11DATE:
11/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Yutian SuTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Oscar Huang conducted an unannounced visit to the day care home for a Case Management inspection. LPA met with Assistant Yutian Su & Rong Yan and informed her of the purpose of the inspection. Licensee Liu was out of the facility for dental appointment.

LPA observed that the facility was operating in compliance with capacity and ratio requirement during the inspection. Present were 11 children in care, of whom three were under two years old and two assistants who are fingerprinted clearances and have current CPR & First Aide certifications during LPA's inspection.

LPA inspected areas both indoor and outdoor the home. Children's files were also reviewed.

In the areas that were evaluated, no regulatory violations were observed at the time of the inspection.

Exit interview was conducted, where this report was reviewed with assistant Yutian Su.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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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