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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434413201
Report Date: 12/13/2023
Date Signed: 01/18/2024 08:24:58 AM

Unsubstantiated


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
11/14/2023 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20231114095003
FACILITY NAME:CHILDREN'S WORLD BILINGUAL MONTESSORIFACILITY NUMBER:
434413201
ADMINISTRATOR:YU-CHIEH HSIUNGFACILITY TYPE:
850
ADDRESS:820 KIELY BLVDTELEPHONE:
(408) 247-8600
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:60CENSUS: 38DATE:
12/13/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Michelle HsiungTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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1. Staff handled daycare child in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted a subsequent complaint inspection to deliver investigation findings today. LPA met with Director Michelle Hsiung.

Interviews were conducted with staff, parents and other parties involved. Staff stated that they have not seen any of the staff handle any of the children in a rough manner. Parents stated that they had no concerns on how the staff are treating their children at the center. Parents stated that the staff are informative and have not seen the staff act inappropriately towards their children. Other parties involved stated that they like the staff and attending the Center.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the above allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

NOTICE OF SITE VISIT WAS ISSUED AND DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
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
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
11/14/2023 and conducted by Evaluator Anna Morales
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20231114095003

FACILITY NAME:CHILDREN'S WORLD BILINGUAL MONTESSORIFACILITY NUMBER:
434413201
ADMINISTRATOR:YU-CHIEH HSIUNGFACILITY TYPE:
850
ADDRESS:820 KIELY BLVDTELEPHONE:
(408) 247-8600
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:60CENSUS: 38DATE:
12/13/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Michelle HsiungTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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9
1. Staff forced daycare child to nap.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted a subsequent complaint inspection to deliver investigation findings today. LPA met with Director Michelle Hsiung.
On 11/3/2023, the Department received the above allegation against the facility. Accompanying video evidence was provided by the reporting party (RP).

LPA conducted unannounced site inspections, interviews, and record reviews.
The investigation revealed that the facility allows parents to view live video footage of the classrooms online. On or about, 10/4/23, video footage shows Child (C1) attempting to get up from the cot during nap time(12:30-2:30pm) more than one time and Staff (S1) did not allow the Child (C1) to get up.
(Continue on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
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 07-CC-20231114095003
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: CHILDREN'S WORLD BILINGUAL MONTESSORI
FACILITY NUMBER: 434413201
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/08/2024
Section Cited
CCR
101223(a)(2)
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Personal Rights:101223(a)(2):To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by:
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Director stated that she will conduct a staff training to ensure that this will not occur again, and will submit the plan along with Staff's signature of attendance by the POC date.
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On or about October 4,2023, video footage shows Staff (S1) did not allow Child (C1) to leave the cot during nap time, which poses/posed a potential health, safety or personal rights risk to persons 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: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 07-CC-20231114095003
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: CHILDREN'S WORLD BILINGUAL MONTESSORI
FACILITY NUMBER: 434413201
VISIT DATE: 12/13/2023
NARRATIVE
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Based on LPA’s observation, the preponderance of evidence standard has been met. Therefore, the above allegations are SUBSTANTIATED. Deficiencies are being cited today an follow on LIC9099D.

NOTICE OF SITE VISIT WAS ISSUED AND DIRECTOR WAS INFORMED TO POST THE NOTICE IN A VISIBLE LOCATION OF THE DAY CARE FOR A PERIOD OF 30 DAYS.

Appeal Rights were given to Director Michelle Hsiung.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4