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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417346
Report Date: 06/26/2024
Date Signed: 06/26/2024 11:35:39 AM

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
06/13/2024 and conducted by Evaluator Yangcheng Huang
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20240613161306
FACILITY NAME:YANG, CHING HSINFACILITY NUMBER:
434417346
ADMINISTRATOR:YANG, CHING HSINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 688-9580
CITY:SAN JOSESTATE: CAZIP CODE:
95139
CAPACITY:14CENSUS: 7DATE:
06/26/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ching Hsin YangTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Licensee is operating out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Oscar Huang conducted an unannounced subsequent inspection to the facility to deliver finding on above allegation. LPA met with licensee, Ching Hsin Yang and explained the nature of today’s inspection to her.

Based on confidential interviews conducted with licensee, reviewed children files, facility records, and LPA's own observations, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12, Chapter 3), are being cited on the attached LIC 9099-D.

A type "A" deficiencies were cited. A notice of site visit was given and must remain posted for 30 days. Exit interview was discussed and verbally translated into Chinese and the report was giving to licensee, Ching Hsin Yang.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
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-20240613161306
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: YANG, CHING HSIN
FACILITY NUMBER: 434417346
VISIT DATE: 06/26/2024
NARRATIVE
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AB633 Parent Notification is required. This page (LIC9099) along with LIC9099-D page shall be provided to all parents of children currently enrolled and any future children being enrolled for the next 12 months per AB633 requirements.

A notice of site visit was issued and posted near the facility entrance along with the Type "A" deficiency and must remain posted for 30 consecutive days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 07-CC-20240613161306
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: YANG, CHING HSIN
FACILITY NUMBER: 434417346
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/28/2024
Section Cited
CCR
102416.5(e)
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Staffing Ratio and Capacity: If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
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Licensee needs to immediately ensure to be in compliance with laws and regulations, and to submit CCL a written statement indicating what steps the licensee is going to implement that she is operating within the required capacity when operates by herself without assistant by the POC due date.
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This requirement was not met as evidenced by: Based on interview with licensee, and facility record reviews, LPA learned there were 4 infants and 1 preschooler (including her own infant and preschool child) in care by licensee only after 1:30pm during operation time. This poses an immediately safety & health risk to children in care.
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According to AB 633, all parents of children currently enrolled and any future children being enrolled for the next 12 months must be provided with this report which contains this Type A deficiency.
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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: 06/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3