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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434413666
Report Date: 03/21/2024
Date Signed: 03/21/2024 03:39:49 PM

Unsubstantiated


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
07/26/2023 and conducted by Evaluator Yangcheng Huang
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230726102747
FACILITY NAME:FAN, LANA & ZHANG, XIAO MINGFACILITY NUMBER:
434413666
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:0CENSUS: 0DATE:
03/21/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lana Fan & Xiao Ming ZhangTIME COMPLETED:
09:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unsafe sleep practices resulting in infant death
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Oscar Huang conducted an unannounced complaint visit and met with the licensee, Xiao Ming Zhang, today. The purpose of LPA’s visit was to deliver the investigation finding on the above allegation. Present during today’s visit was the licensee, Xiao Ming Zhang only during today's inspection.

The investigation was conducted by IB Investigator, Eddie Phung. IB Investigator conducted interviews with licensees, parents of children in care, San Jose police, as well as reviewed children records and hospital medical records, including coroner's report that C1's cause of death was sudden infant death syndrome (SIDS) during the investigation of the allegation noted above.

IB Investigator concluded that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

The report was discussed and verbally translated into Chinese during the exit interview with Licensee, Xiao Ming Zhang.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Yangcheng Huang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
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 1