<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417375
Report Date: 05/23/2025
Date Signed: 05/23/2025 04:30:15 PM

Document Has Been Signed on 05/23/2025 04:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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:ZHANG, PEIMINGFACILITY NUMBER:
434417375
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 2DATE:
05/23/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:zhang, Peiming TIME VISIT/
INSPECTION COMPLETED:
04:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Kate Huang met with licensee, Zhang, Peiming for an unannounced Case Management Inspection in response to licensee's increase capacity request . LPA explained the nature of today’s inspection to Licensee. LPA observed licensee and two infants present. Days and hours of operation are Monday to Friday, 8:30am to 6:00pm. The adults that reside in the home are licensee, her spouse, brother and sister-in-law.

Upon arriving at the facility around 12:45 PM, the LPA observed an infant lying in a bouncer without being strapped in, positioned in the yard just outside the room. The licensee was seated behind the infant and engaged in a phone conversation at the time.

LPA toured the indoor and outdoor areas of the home during today's inspection with the licensee. Required materials were observed posted near the entrance. In the children's bathroom, multiple bottles of shampoo, conditioner, and other similar items were observed to be accessible to children. The LPA advised the licensee to move all such items to a location that is inaccessible to children. LPA observed sufficient materials, toys, and play equipment for the day care children. The home has heating and ventilation for comfort of children. LPA observed a fully charged fire extinguisher and working smoke/carbon monoxide detectors. The Licensee states that she does not have any weapons in the home.

LPA observed licensee has current CPR and First Aid certification, which will expire in 08/2025. LPA observed a current roster of the children and a fire and disaster drills log which is done every six months. The last drill was conducted in January 2025 .



LPA reviewed the files of three enrolled children. One of the three files did not have the LIC 627 (Consent for Emergency Medical Treatment), one did not have the LIC 9224, and one did not have the LIC 282.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: ZHANG, PEIMING
FACILITY NUMBER: 434417375
VISIT DATE: 05/23/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A fire clearance granted from San Jose Fire Department was received on 04/28/2025: Fire clearance granted; no violations found. All the on-limit area for daycare use is approved.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

One Type-A deficiency and two Type-B deficiencies were cited. Based on today's inspection, the LPA advised the licensee, Zhang Peiming, that the large Family Child Care Home license will be pending a management review.

LPA informed licensee that this report dated on 05/23/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA informed the licensee to provide a copy of this licensing report dated on 05/23/2025 that documents any Type A citation 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 (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Linke Huang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 05/23/2025 04:30 PM - It Cannot Be Edited


Created By: Linke Huang On 05/23/2025 at 03:31 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ZHANG, PEIMING
FACILITY NUMBER: 434417375

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/23/2025
Section Cited
CCR
102423(a)(2)

1
2
3
4
5
6
7
102423 Personal Rights(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
1
2
3
4
5
6
7
Licensee removed the bouncer immediately to the "off-limit" area per LPA's request.
Licensee to provide a plan of correction by the POC due date.
8
9
10
11
12
13
14
(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above because LPA observed an infant lying in a bouncer without being strapped in, located outside the room in the yard which poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Type B
05/30/2025
Section Cited
CCR102417(m)(3)

1
2
3
4
5
6
7
102417Operation of a Family Child Care Home(m)The licensee or registrant shall maintain one of the following:(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state
1
2
3
4
5
6
7
8
9
10
11
12
13
14
This requirement is not met as evidenced by: Based on file review, the licensee did not comply with the section cited above becauseOne of the three files did not have the LIC 627, one did not have the LIC 9224, and one did not have the LIC 282 which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Linke Huang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2025


LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 05/23/2025 04:30 PM - It Cannot Be Edited


Created By: Linke Huang On 05/23/2025 at 04:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ZHANG, PEIMING
FACILITY NUMBER: 434417375

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2025
Section Cited
CCR
102417(g)(4)

1
2
3
4
5
6
7
102417Operation of a Family Child Care Home (g)The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:(4)
Poisons, detergents, cleaning compounds, medicines, firearms and
1
2
3
4
5
6
7
Licensee to submit a plan of correction and picture by the POC due date.
8
9
10
11
12
13
14
other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above because multiple bottles of shampoo, conditioner, and other similar items were observed to be accessible to children in the children's bathroom which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Linke Huang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2025


LIC809 (FAS) - (06/04)
Page: 4 of 5