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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700316
Report Date: 05/11/2022
Date Signed: 05/11/2022 12:00:07 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2022 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20220503134908
FACILITY NAME:LIEN, SHUANGFACILITY NUMBER:
015700316
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shuang LienTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility is over capacity for infants
INVESTIGATION FINDINGS:
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On 05/11/2022 Licensing Program Analysts (LPAs) Jaylena Miller and April Wright conducted an initial 10 day complaint investigation. LPAs met with Licensee, Shuang "Connie" Lien. Present for the inspection were 2 staff members, 6 infants and 2 preschoolers. Per California Code of Regulations Title 22, Division 12 Chapter 1 Article 06 section 102416.5(b)(1)(2) Staffing Ratio and Capacity compliance was not met. As a result, a Type A deficiency is being cited today. Please see LIC 9099-D for deficiency.

The licensee must post this report for thirty days. The licensee must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. This report must remain on file for three years. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was provided and must be posted for thirty days. Exit interview conducted with Licensee, Shuang Lien.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2022 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20220503134908

FACILITY NAME:LIEN, SHUANGFACILITY NUMBER:
015700316
ADMINISTRATOR:LIEN, SHUANGFACILITY TYPE:
810
ADDRESS:7783 TAMARACK DR.TELEPHONE:
(510) 386-1921
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:8CENSUS: 8DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shuang LienTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Licensee is not residing at this facility
INVESTIGATION FINDINGS:
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On 05/11/2022 Licensing Program Analysts (LPAs) Jaylena Miller and April Wright conducted an initial 10 day complaint investigation. LPAs met with Licensee Shuang "Connie" Lien. Present for the inspection were 2 staff members, 6 infants and 2 preschoolers. Licensee arrived around 10:30am. LPA asked licensee if she lives here and licensee stated, “only sometimes”. LPA reminded licensee that she must fully live here and that was a requirement of the license. As a result, A Type A deficiency of the Health and Safety Code 1597.45(a) will be cited today. Please see LIC 9099-D for deficiency.
The licensee must post this report for thirty days. The licensee must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. This report must remain on file for three years. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was provided and must be posted for thirty days. Exit interview conducted with Licensee, Shuang Lien.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 52-CC-20220503134908
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIEN, SHUANG
FACILITY NUMBER: 015700316
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/11/2022
Section Cited
HSC
1597.45(a)
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1597.45 Small family day care homes
All of the following shall apply to small family day care homes:
(a) The use of a single-family residence as a small family day care home shall be considered a residential use of property for the purposes of all local ordinances. This was not met as evidence by:
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POC: Licensee must provide a statement stating that she will be living at the residence as long as she is the licensee of the home. Licensee must submit statement by 5/12/2022.
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Based on interviews and observation, licensee is not currently living at the residence of the family day care home, 7783 Tamarack Dr Dublin, CA 94568. This poses/posed an immediate health and safety risk to persons and children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected. A Non-Compliance Conference will be scheduled at a later date.
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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: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 52-CC-20220503134908
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIEN, SHUANG
FACILITY NUMBER: 015700316
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/11/2022
Section Cited
CCR
102416.5(b)(1)(2)
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102416.5 Staffing Ratio and Capacity
(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time...shall be one of the following: (1) Four infants; or (2) Six children, no more than three of whom are infants. This requirement was not met as evidence by:
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Licensee will disenroll 2 infants from the facility and either have 4 infants only or 3 infants and 3 preschoolers. Licensee will also review licensing staffing ratio and capacity regulation and watch video on How many children can attend a FCCH (on licensing website) and submit a written plan of action on how she will ensure she is in complaiance by 5/12/2022.
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Based on physical plant inspection, observation and records review the facility did not ensure proper ratio and capacity as there are 6 infants and 2 preschoolers present during the inspection. which poses an immediate risk to the health and safety of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected. A Non-Compliance Conference will be scheduled at a later date.
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: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4