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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434415225
Report Date: 09/10/2024
Date Signed: 09/10/2024 04:01:24 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
07/29/2024 and conducted by Evaluator Manel Estoesta
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240729112539
FACILITY NAME:LIU, CUIHONGFACILITY NUMBER:
434415225
ADMINISTRATOR:LIU, CUIHONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 857-9063
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:14CENSUS: DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee Cuihong LiuTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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9
1. Personal Rights - Child sustained unexpained injury while in care.
INVESTIGATION FINDINGS:
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On 9/10/2024 at 3 pm, Licensing Program Analyst (LPA) Manel Estoesta conducted a Complaint Investigation. LPA met with the Licensee Cuihong Liu and explained the nature of the visit. Present on this visit were the Licensee’s Spouse Tiecheng Hu, Licensee’s Assistant Jia Zhou and 14 children in care. The home operates from Monday to Friday from 8:30 am to 6pm.

Licensee speaks Mandarin. LPA contacted Language Interpreter for assistance.

Reporting Party (RP) alleged that C1 sustained unexplained injury while in care.

On 6/9/2022, sometime in the afternoon, P1 was notified via phone that C1’s upper left eyebrow area was “scraped” by a safety pin that was on the bedding, this happened during afternoon nap time. C1 received a medical assessment on 6/9/2022 at 7:22 pm. Based on record review that C1 had a laceration on left eyebrow without complication. The Licensee did not report the incident to the Regional Office. Neither the Licensee and or the Licensee’s provider witness the incident.
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 6
Control Number 52-CC-20240729112539
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: LIU, CUIHONG
FACILITY NUMBER: 434415225
VISIT DATE: 09/10/2024
NARRATIVE
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Based on LPA Estoesta’s Record Review and Staff Interview, the preponderance of evidence standard has been met, therefore the above allegations are to be SUBSTANTIATED.

The Licensee is in violation of Section 102423 Personal Rights (a) (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment…

LPA Estoesta informed the Licensee that this report dated 9/10/2024 included a Type B Citation which can be posted as there is potential risk to the health, safety, or personal rights of children in care.

For Child Care Transparency Website (Licensing Facility Inspection Reports), please follow the links below;


https://cdss.ca.gov/inforesources/community-care-licensing/facility-search-welcome
https://www.ccld.dss.ca.gov/carefacilitysearch/

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee Cuihong Liu.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
07/29/2024 and conducted by Evaluator Manel Estoesta
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240729112539

FACILITY NAME:LIU, CUIHONGFACILITY NUMBER:
434415225
ADMINISTRATOR:LIU, CUIHONGFACILITY TYPE:
810
ADDRESS:418 CORINTHIA DRIVETELEPHONE:
(510) 857-9063
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:14CENSUS: DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee Cuihong LiuTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
2. Reporting Requirements - Licensee did not report a child's injury to the Department.
INVESTIGATION FINDINGS:
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On 9/10/2024 at 3 pm, Licensing Program Analyst (LPA) Manel Estoesta conducted a Complaint Investigation. LPA met with the Licensee Cuihong Liu and explained the nature of the visit. Present on this visit were the Licensee’s Spouse Tiecheng Hu, Licensee’s Assistant Jia Zhou and 14 children in care. The home operates from Monday to Friday from 8:30 am to 6pm.

Licensee speaks Mandarin. LPA contacted Language Interpreter for assistance.

Reporting Party (RP) alleged that Licensee did not report a child's injury to the Department.

On 6/9/2022, sometime in the afternoon, P1 was notified via phone that C1’s upper left eyebrow area was “scraped” by a safety pin that was on the bedding, this happened during nap time. C1 received a medical assessment on 6/9/2022 at 7:22 pm. Based on record review that C1 had a laceration on left eyebrow without complication.
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 52-CC-20240729112539
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: LIU, CUIHONG
FACILITY NUMBER: 434415225
VISIT DATE: 09/10/2024
NARRATIVE
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The Licensee did not report the incident to the Regional Office. Neither the Licensee and or the Licensee’s provider witness the incident. The Licensee only send a completed LIC 624 (CH) on Wednesday, July 31, 2024 7:37 PM via email to LPA Estoesta.

Based on LPA Estoesta’s Record Review and Staff Interview, the preponderance of evidence standard has been met, therefore the above allegations are to be SUBSTANTIATED.

The Licensee is in violation of 102416.2 Reporting Requirements (b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. (3) Health and Safety Code Section 1597.467(b)(1) provides in part: (B) Any injury to any child that requires medical treatment...

LPA Estoesta informed the Licensee that this report dated 9/10/2024 included a Type B Citation which can be posted as there is potential risk to the health, safety, or personal rights of children in care.

For Child Care Transparency Website (Licensing Facility Inspection Reports), please follow the links below;


https://cdss.ca.gov/inforesources/community-care-licensing/facility-search-welcome
https://www.ccld.dss.ca.gov/carefacilitysearch/

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee Cuihong Liu.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 52-CC-20240729112539
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: LIU, CUIHONG
FACILITY NUMBER: 434415225
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
102416.2(b)(3)(B)
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 102416.2 Reporting Requirements (b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. (3) Health and Safety Code Section 1597.467(b)(1) provides in part: (B) Any injury to any child that requires medical treatment...
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Licensee submitted an LIC 624 B (CH) on Wednesday, July 31, 2024 7:37 PM. LPA suggested to the Licensee to review and watch the Family Child Care Providers, https://ccld.childcarevideos.org/family-child-care-providers/, including the Children’s Personal Rights in Child Care and the Child Care Reporting Requirements.
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This requirement is not met as evidenced by, on 6/9/2022, sometime in the afternoon, P1 was notified via phone that C1’s upper left eyebrow area was “scraped” by a safety pin that was on the bedding, this happened during nap time. C1 received a medical assessment on 6/9/2022 at 7:22 pm. Based on record review that C1 had a laceration on left eyebrow without complication. The Licensee did not report the incident to the Regional Office. This poses a potential risk to the health, safety or personal rights to children in care.
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The Licensee will send a letter to the Regional Office, confirming the requirement above. LPA provided a copy of the LIC 624 B (CH) for reference.
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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: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6
Control Number 52-CC-20240729112539
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: LIU, CUIHONG
FACILITY NUMBER: 434415225
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
102423(a)(2)
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102423 Personal Rights (a) (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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7
LPA suggested to the Licensee to review and watch the Family Child Care Providers, https://ccld.childcarevideos.org/family-child-care-providers/, including the Children’s Personal Rights in Child Care and the Child Care Reporting Requirements.
8
9
10
11
12
13
14
This requirement is not met as evidenced by, on 6/9/2022, sometime in the afternoon, P1 was notified via phone that C1’s upper left eyebrow area was “scraped” by a safety pin that was on the bedding, this happened during nap time. C1 received a medical assessment on 6/9/2022 at 7:22 pm. Based on record review that C1 had a laceration on left eyebrow without complication. The Licensee did not report the incident to the Regional Office. Neither the Licensee and or the Licensee’s provider witness the incident. This poses a potential risk to the health, safety or personal rights to children in care.
8
9
10
11
12
13
14
The Licensee will send a letter to the Regional Office, confirming the requirement above.
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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: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6