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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417297
Report Date: 07/28/2025
Date Signed: 07/29/2025 01:29:32 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
07/24/2025 and conducted by Evaluator Syhshyan Yu
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250724083701
FACILITY NAME:QU, QINGFACILITY NUMBER:
434417297
ADMINISTRATOR:QU, QINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 394-7566
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY:14CENSUS: 12DATE:
07/28/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Qing QuTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Shine Yu, conducted an unannounced initial complaint investigation of the above allegation. LPA informed licensee the above allegation and was met with licensee, Qing Qu.

Licensee accompanied LPA to tour facility and play yard area. LPA observed licensee, 1 staff and 12 children. LPA interviewed licensee and staff. LPA reviewed children records, on 6/16/2025 to 06/19/2025, there were 5 infants (C1-C5) in child care home which was over staffing ratio and capacity.

Based on interviews, observations, and information gathered by LPA, it was found the allegation is SUBSTANTIATED; A finding that is SUBSTANTIATED means the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

As a result, one type A deficiency was cited on the following page and copy of Appeal Rights was given. Exit interview conducted in Mandarin with Licensee, Qing Qu.
A notice of site visit was issued and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2025
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-20250724083701
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: QU, QING
FACILITY NUMBER: 434417297
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2025
Section Cited
CCR
102416.5(d)(1)
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Staffing Ratio and Capacity (d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
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By POC due date: 07/29/25, Licensee states that she will submit a written plan to ensure that the facility is within the required ratio and capacity at all times.
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(1) Twelve children, no more than four of whom may be infants;

This requirement was not met as evidenced by:

Based on LPA observations and interviews, the facility was out of ratio on 6/16/2025 to 06/19/2025, there were 5 infants (C1-C5) in child care home which was over staffing ratio and capacity. This poses an immediate risk to the health, safety, and personal rights to children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
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CCR
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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: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3