434416877-1-7-2026-07-CC-LHUG-DQ4QM2-20260107111650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416877
Report Date: 01/07/2026
Date Signed: 01/07/2026 11:17:07 AM

Document Has Been Signed on 01/07/2026 11:17 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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	JAFARNEJAD, ZHI LING		FACILITY NUMBER:	434416877
ADMINISTRATOR/ DIRECTOR:	ZHI LING JAFARNEJAD		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 637-0963
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95124
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	01/07/2026
TYPE OF VISIT:	Office	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Jafarnejad, Zhi Ling		TIME VISIT/ INSPECTION COMPLETED:	11:00 AM

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	On 01/07/2026, Licensing Program Manager (LPM) Gladys Kuizon and Licensing Program Analyst (LPA) Kate Huang met with Licensee Zhi Ling Jafarnejad for a scheduled Informal Meeting at the San Jose Regional Office. The purpose of the Informal Meeting was to discuss recent citations issued. 1. Staff immunization On 09/25/2025, Licensee received a TYPE B citation under HSC 1597.622(a)(1) for allowing staff who does not have required immunization to care for children. 2. Mandated Reporter Training On September 25, 2025, the Licensee was cited a Type B deficiency under HSC 1596.8662(b)(1) for failing to ensure that all staff maintained current Mandated Reporter training certificates. The original report dated September 25, 2025, was amended during today’s meeting to correct the cited regulation; the initially cited section 1596.8662(c)(1) was revised to section 1596.8662(b)(1). 3. Infant Safe Sleep On 10/08/2025, Licensee received a TYPE B citation under California Code of Regulations (CCR) 102425(j)(5) for not properly supervising napping infants. Infants were napping in a room with the door closed and no staff in the room. 4. Licensee does not live in the Family Child Care Home (FCCH) On 10/08/2025, Licensee received a TYPE B citation for not living in the home as required by Health & Safety Code (HSC) 1596.78(a). 5. Criminal Record Clearance On 12/15/2025, Licensee received a TYPE A citation under HSC 1596.871(b)(1) for allowing uncleared staff to be present in the facility and work with children. Uncleared staff was working in the facility from October 2024 to June 2025 without required criminal background clearance. During today’s Informal Meeting, Type A and Type B citations were discussed with Licensee. The purpose of the informal meeting today is to review the deficiencies with Licensee and discuss the plan of corrections submitted by the licensee to ensure licensees understanding of Title 22 violations that led to the deficiencies.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: JAFARNEJAD, ZHI LING	FACILITY NUMBER: 434416877
	VISIT DATE: 01/07/2026

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Additionally, LPM discussed the facility’s discipline policies with the Licensee. LPM emphasized the importance of maintaining required ratios and licensed capacity, and complying with infant safe sleep regulations. LPM also emphasized that children’s personal rights must not be violated, including no corporal punishment. During the meeting, the Licensee provided a detailed plan of correction regarding hiring procedures to ensure employees possess all required records and certificates, including criminal background clearance.

LPM, Gladys Kuizon explained to Licensee the seriousness of these violations and that if there is continued non-compliance, the day care home may be referred to the Legal Department for possible administrative action, which could include revocation of the day care license and exclusion of the Licensee from community care facilities licensed by the Department.

LPM Kuizon and LPA Huang also discussed the Technical Support Program ("TSP") with the licensee. Licensee agreed to be referred to TSP.

During the meeting, the licensee confirmed that she understood all the regulations and requirements discussed today.

LPM Kuizon also discussed the requirements of AB 633 with Licensee and provided her with the AB 633 fact sheet and a copy of LIC9224 "Acknowledgement of Receipt of Licensing Reports."
This report was reviewed with Licensee and a copy was provided to Licensee at the conclusion of the Informal. This meeting was conducted in English with Mandarin translation provided by LPA as needed.

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/07/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC809 (FAS) - (06/04)

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