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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417290
Report Date: 12/06/2022
Date Signed: 12/06/2022 02:44:04 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 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
11/30/2022 and conducted by Evaluator Yangcheng Huang
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20221130132144
FACILITY NAME:BAI, YAPINGFACILITY NUMBER:
434417290
ADMINISTRATOR:BAI, YAPINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 476-7600
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 12DATE:
12/06/2022
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Yaping BaiTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Alterations to existing fence to allow access to another property
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Oscar Huang, conducted an unannounced initial 10-day complaint investigation to the Facility. LPA Huang met with Licensee, Yaping Bai and explained the nature of today's visit to her.
LPA observed a gate was installed on the fence dividing the Licensee's property and the property to the right of Licensee's home without notifying the department.
LPA Huang interviewed licensee and obtained copies of pertinent information.
Based on LPA’s observations, records reviewed, and interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on the next page. Licensee/Director was informed that failure to correct the deficiencies may result in civil penalties.

A notice of site visit was issued and must be posted near the facility entrance and must remain posted for 30 consecutive days. The report was discussed and verbally translated into Chinese during the exit interview with Licensee, Yaping Bai.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
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 2
Control Number 07-CC-20221130132144
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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: BAI, YAPING
FACILITY NUMBER: 434417290
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/20/2022
Section Cited
CCR
102416.3(a)
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Alterations to Existing Buildings or Grounds- (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed
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Licensee agreed to be in compliance with the regulation and to submit the updated sketches & a statement to the deparment, and also to inform parents of children in care for the purposes of using the gate to the office prior to the POC due date.
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This requirement is not met as evidenced by: Based on LPA’s observations, records reviewed, and interviews conducted, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons 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: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
LIC9099 (FAS) - (06/04)
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