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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434417356
Report Date: 08/15/2025
Date Signed: 08/21/2025 11:41:04 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
06/26/2025 and conducted by Evaluator Syhshyan Yu
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20250626120228
FACILITY NAME:CHEN, SIXINFACILITY NUMBER:
434417356
ADMINISTRATOR:CHEN, SIXINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 933-7482
CITY:SUNNYVALESTATE: CAZIP CODE:
94085
CAPACITY:14CENSUS: 6DATE:
08/15/2025
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:SiXin ChenTIME COMPLETED:
10:10 AM
ALLEGATION(S):
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Adult hit a daycare child while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shine Yu conducted an unannounced Complaint investigation to deliver the findings. LPA met with Licensee SiXin Chen. Present during visit were licensee, 2 staff, and 6 preschool aged children.

It was alleged that a teacher slapped child. (C1)

On 6/27/2025, LPA conducted phone interview with Reporting Party(RP). RP stated they are working with police to set up an interview with C1.
On 6/30/2025, LPA conducted an initial complaint investigation and reviewed supporting documentation. LPA interviewed licensee and two staff, and toured facility.
On 8/06/2025, LPA conducted phone interviews with parents and left messages for parents to call back. None was received. LPA also conducted additional phone interview with RP.

(continue on page 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025
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 2
Control Number 07-CC-20250626120228
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: CHEN, SIXIN
FACILITY NUMBER: 434417356
VISIT DATE: 08/15/2025
NARRATIVE
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On 8/07/2025 The Department received a call from police detective who confirmed that their investigation will be closed with no substantiative finding. Detective also confirmed no interview of C1 was conducted due to C1’s age.

Throughout the investigation process, it was found the allegation is UNSUBSTANTIATED; based on interviews, observations, and information gathered by LPA. A finding that is UNSUBSTANTIATED means although the allegation may have happened or is valid, the preponderance of evidence does not prove it.

Exit interview conducted and copy of this report was reviewed with the Licensee SiXin Chen.
A copy of Appeal Rights was given. NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Syhshyan Yu
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2