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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417126
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:50:23 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/08/2024 and conducted by Evaluator Melvin S Matos
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240208121428
FACILITY NAME:JY INTERNATIONAL GROUPFACILITY NUMBER:
434417126
ADMINISTRATOR:THERESA CAMPBELLFACILITY TYPE:
850
ADDRESS:755 SOUTH BERNARDO AVENUETELEPHONE:
(408) 348-9618
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:120CENSUS: 10DATE:
03/20/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Zengqiang Wang & Sepideh SotoudehTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Facility is operating beyond the scope of the license.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Mel Matos and Mandeep Kaur met with Zengqiang Wang, Licensee representative, and Sepideh Sotoudeh, interim director, for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. Based on interviews, record reviews, and evidence gathered during the investigation process, the Department concludes that the Facility was operating beyond the scope of the license when it allowed one child (22 months) to attend the Facility starting 12/07/23. The Facility is licensed to serve children, ages 2-5 years of age. The allegation noted above is thus found to be SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met.
A "Type B" deficiency is being cited on the attached LIC 9099-D. Exit interview conducted and report was reviewed with the Licensee representative. Zengqiang Wang, and interim director, Sepideh Sotoudeh. Notice of site visit issued and must remain posted for 30 days. Appeal rights were provided to Zengqiang and Sepideh prior to conclusion of today's inspection.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 07-CC-20240208121428
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: JY INTERNATIONAL GROUP
FACILITY NUMBER: 434417126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/26/2024
Section Cited
CCR
101161(a)
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Limitations on Capacity: A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by:
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Licensee representative, Zengqiang Wang, agreed to submit a written/signed letter acknowledging that it understands the scope of the license, including ages of children to be served, and that the Facility will
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the Facility was operating beyond the scope of the license when it allowed one child (22 months) to attend the Facility starting 12/07/23. This presents a potential risk to the health, safety, or personal rights of children in care.
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be in compliance with the conditions and limitations specified on the license at all times.

Written Plan of Correction due by Tuesday March 26, 2024.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/08/2024 and conducted by Evaluator Melvin S Matos
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240208121428

FACILITY NAME:JY INTERNATIONAL GROUPFACILITY NUMBER:
434417126
ADMINISTRATOR:THERESA CAMPBELLFACILITY TYPE:
850
ADDRESS:755 SOUTH BERNARDO AVENUETELEPHONE:
(408) 348-9618
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:12CENSUS: 10DATE:
03/20/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Zengqiang Wang & Sepideh SotoudehTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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9
Staff do not ensure children's toileting areas are adequately cleaned.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Mel Matos and Mandeep Kaur met with Zengqiang Wang, Licensee representative, and Sepideh Sotoudeh, interim director, for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings.
Based on interviews, observations, and evidence gathered during the investigation process, it is concluded that although the allegation (staff do not ensure children's toileting areas are adequately cleaned) noted on this complaint may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. The allegation is UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the Licensee representative. Zengqiang Wang, and interim director, Sepideh Sotoudeh. Notice of site visit issued and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3