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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417192
Report Date: 06/12/2025
Date Signed: 06/12/2025 03:34:27 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 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
05/07/2025 and conducted by Evaluator Mandeep Kaur
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250507090337
FACILITY NAME:BUILDING KIDZ SANTA CLARAFACILITY NUMBER:
434417192
ADMINISTRATOR:AJANTA DASFACILITY TYPE:
860
ADDRESS:1500 LOS PADRES BLVD,#110,#111TELEPHONE:
(408) 758-1883
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY:79CENSUS: 45DATE:
06/12/2025
UNANNOUNCEDTIME BEGAN:
01:09 PM
MET WITH:Miao Li and Hong NiTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff handled day care child in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst(LPA) Mandeep Kaur met with Licensee representative, Miao Li and Director, Hong Ni for an unannounced follow up complaint investigation. Purpose of today's investigation: deliver investigation findings. LPA conducted observations, interviewed staff, reviewed records, reviewed staff files and gathered evidence during the investigation. LPA toured inside areas of the facility during investigation.

During today's investigation, LPA reviewed the video clip of classroom D2, of 04/24/2025, where staff (S1 and S2) were present with children during nap time in classroom D2, with Licensee Representative and Director. LPA interviewed Licensee representative and Director during today's investigation.


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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2025
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-20250507090337
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: BUILDING KIDZ SANTA CLARA
FACILITY NUMBER: 434417192
VISIT DATE: 06/12/2025
NARRATIVE
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Based on evidence gathered, the Department concludes that staff(S1) handled day care child in a rough manner. Therefore, the above allegation is SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met.

During today's investigation, One "Type A" deficiency is being cited on the attached LIC 9099-D. Appeal rights provided.

Exit interview conducted and report was reviewed with Licensee representative, Miao Li and Director, Hong Ni. A notice of site visit has been issued and must remain posted for 30 days.

LPA informed Licensee Representative and Director that this report dated 06/12/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Assembly bill 633 was provided and discussed with Licensee Representative and Director. LPA informed Licensee Representative and Director to provide a copy of this licensing report dated 06/12/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), must be placed in the child's file for verification.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20250507090337
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: BUILDING KIDZ SANTA CLARA
FACILITY NUMBER: 434417192
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/13/2025
Section Cited
CCR
101223(a)(3)
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Personal Rights: (a)The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.

This requirement is not met as evidenced by:
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By Plan of correction due date, 06/13/2025, Licensee will submit a proof of in-service training conducted to staff regarding Personal rights of the children to the department. Licensee will also submit a written plan of action indicating what steps will be implemented to ensure that each child in day care center is accorded the personal rights within Title 22 regulations section code: 101223 requirements to the department.
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Based on evidence gathered and review of video clip of 04/24/25 of Room D2 during nap time where staff(S1&S2) are present, with Licensee Representative and Director throughout the investigation, staff(S1) handled day care child(C1) in a rough manner, which poses an immediate risk to the health, safety and personal rights of children in care.
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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: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3