384002995-4-5-2021-05-CC-AZEA-C23TSE-20210414145859

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384002995
Report Date: 04/02/2021
Date Signed: 04/05/2021 12:19:02 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/08/2021 and conducted by Evaluator Cindy Mok

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210208102144

FACILITY NAME:	LIANG, WEI YING		FACILITY NUMBER:	384002995
ADMINISTRATOR:	LIANG, WEI YING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 613-6847
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94134
CAPACITY:	14	CENSUS: 4	DATE:	04/02/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Wei Ying Liang (Tracy)		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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The facility administered medications to a child.

INVESTIGATION FINDINGS:

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Licensing Program Analyst, Mok, finalized this complaint via the phone with the licensee, Wei Ying Liang (Tracy), because CDSS suspended the field inspections temporarily during the COVID19 pandemic. This report was delivered to the licensee via e-mail and mail. During the investigation, LPA conducted interviews with the staff, witnesses and gathered relevant documents. The facility has different types of toys available for the children to play with daily. One of the toys is a Doctor Kit. The child played with staff as a doctor or patient during care. Based on the interviews, there was no sufficient evidence to prove the facility administered medications to a child.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore the allegation is Unsubstantiated.”

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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