<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416545
Report Date: 01/09/2025
Date Signed: 01/09/2025 04:12:07 PM

Document Has Been Signed on 01/09/2025 04:12 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:WANG, WENJINGFACILITY NUMBER:
434416545
ADMINISTRATOR/
DIRECTOR:		WENJING WANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 669-9467
CITY:SAN JOSESTATE: CAZIP CODE:
95131
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
01/09/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Wenjing WangTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Mel Matos and Syeda Bahar met with Wenjing Wang, Licensee, for an unannounced case management inspection. LPAs also observed one adult assistant (Qiqi Huang) and eight day care children (4 infants & 4 preschool) in the day care during today's inspection.

Licensee submitted an updated Facility sketch prior to today's inspection requesting to add her backyard to the "on limits" area and make the front yard off limits. A fire safety inspection approval was received from the San Jose Fire Department prior to today's inspection.

LPAs toured the indoor and outdoor areas of the Facility during today's inspection. LPAs conclude that the backyard area of the home (minus left/right/back sides - off limits) is safe for the day care children. LPAs also reviewed one adult assistant file during today's inspection. Adult assistant file was complete with the required forms.

Off limit areas inside the home: barricaded fireplace in the living room area, bedrooms 1 & 2, 1 bathroom, and attached garage. Off limit area outside the home: entire front yard and left/right/back side of the backyard.

Exit interview conducted and report was reviewed with the Licensee, Wenjing Wang. 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: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1