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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434417366
Report Date: 12/18/2023
Date Signed: 12/18/2023 03:54:41 PM

Document Has Been Signed on 12/18/2023 03:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CHENG,HSIAO-YING&NAZARENO,REGINALD&HUANG,TIEN-HSINFACILITY NUMBER:
434417366
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
12/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Hsiao Ying Cheng, Reginald Nazareno, & Tien-Hsin HuangTIME COMPLETED:
04:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Mel Matos met with Hsiao-Ying Cheng, Reginald Nazareno, & Tien-Hsin Huang, Licensees, for an unannounced case management inspection. LPA also observed five day care children (2 infants, 2 preschool, and Licensee's 9 year old son) in the home during today's inspection.

A copy of the fire/disaster drill log was provided to the Licensees during today's inspection. Licensees were reminded that fire/disaster drills must be completed at least once every six months.

Licensees states that the day care will be closed from December 22, 2023 to January 7, 2024 for the Christmas/New Year's holiday break.

Exit interview conducted and report was reviewed with the Licensees, Hsiao-Ying Cheng, Reginald Nazareno, and Tien-Hsin Huang. No deficiencies issued.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1