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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417978
Report Date: 03/24/2026
Date Signed: 03/24/2026 04:39:05 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
03/23/2026 and conducted by Evaluator Linke Huang
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20260323105930
FACILITY NAME:MENG, QINGYIFACILITY NUMBER:
434417978
ADMINISTRATOR:QINGYI MENGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 229-3530
CITY:SAN JOSESTATE: CAZIP CODE:
95129
CAPACITY:14CENSUS: 5DATE:
03/24/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Meng, QingyiTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Affidavits were not signed by each parent of a child enrolled in the home, even though the facility does not carry liability insurance.
The licensee signed the landlord’s signature on the landlord consent form without landlord's permission.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kate Huang conducted an unannounced complaint investigation at the facility. LPA met with Licensee Meng, Qingyi and explained the nature of today’s visit. Present were licensee, one assistant, one infant and four preschoolers.

During today’s visit, the licensee stated that she plans to obtain liability insurance for the daycare and is still in contact with the insurance company, but has not yet purchased the insurance. LPA reviewed the records of all five enrolled children and found that none of the files contained a signed LIC 282, Affidavit Regarding Liability Insurance, from the parents.

The licensee stated that she signed the landlord’s name on the landlord consent form. Based on an interview with the landlord, he stated that he never gave the licensee permission to sign the document on his behalf.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
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 4
Control Number 07-CC-20260323105930
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: MENG, QINGYI
FACILITY NUMBER: 434417978
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2026
Section Cited
CCR
102417(m)(3)
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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.
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Licensee to provide a plan of correction by the POC due date.
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This requirement is not met as evidenced by: Based on records review, none of the present children's files contained a signed LIC 282, Affidavit Regarding Liability Insurance, from the parents, which posed a potential risk to the health and safety of the 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: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 07-CC-20260323105930
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: MENG, QINGYI
FACILITY NUMBER: 434417978
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2026
Section Cited
CCR
102402(a)(3)
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102402 Revocation or Suspension of a License or Registration (a) The Department shall have the authority to suspend or revoke any license for the following reasons: (3) Conduct in the operation or maintenance of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California.
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Licensee to provide a plan of corretion by the POC due date.
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This requirement is not met as evidenced by: Based on records review and interviews, licensee admitted that she signed the landlord’s name on the landlord consent form, which posed an immediate risk to the health and safety of the 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: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20260323105930
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: MENG, QINGYI
FACILITY NUMBER: 434417978
VISIT DATE: 03/24/2026
NARRATIVE
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Based on the available evidence, the preponderance of evidence standard has been met and therefore the above allegations were Substantiated.

One Type A deficiency and one Type B deficiency were cited today.

LPA Huang informed the licensee that this report dated 03/24/2026 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Huang informed the licensee to provide a copy of this licensing report dated 03/24/2026 that documents a 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.

Exit interview was conducted, where the report was reviewed and discussed with the licensee, Meng, Qingyi in Mandarin. A notice of site visit has been issued and must remain posted for 30 days. A copy of this report was provided along with licensee's appeal rights.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Linke Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4