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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412837
Report Date: 03/22/2023
Date Signed: 03/22/2023 09:32:09 AM

Document Has Been Signed on 03/22/2023 09:32 AM - 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-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LUN, XIAOQINGFACILITY NUMBER:
434412837
ADMINISTRATOR:LUN, XIAOQINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 898-4407
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 4DATE:
03/22/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Xiaoqing LunTIME COMPLETED:
09:45 AM
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) Oscar Huang conducted an unannounced case management - incident inspection to the facility in regard to the department receive a call from City of Sunnyvale Public Safety Services Neighborhood Preservation regarding a report against the roof leaking in the facility. Upon arrived, LPA met with Licensee, Xiaoqing Lun and explained the nature of today’s inspection to her. Present were 4 preschoolers in the home during today's inspection.

LPA conducted a tour to the entire home both indoor and outdoor including all the rooms, garage, and playyard. LPA did not observed any roof leakage, water accumulation in the house or around the house.

Exit interview conducted with licensee. The report was discussed and verbally translated into Chinese during the exit interview with Licensee, Xiaoqing Lun. No deficiency was cited. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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 1