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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700335
Report Date: 08/17/2022
Date Signed: 08/18/2022 02:57:06 PM

Document Has Been Signed on 08/18/2022 02:57 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZHENG, XINGXINFACILITY NUMBER:
435700335
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
08/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Xingxin ZhengTIME COMPLETED:
02:15 PM
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On Wednesday, August 17, 2022 at 1 pm, Licensing Program Analyst (LPA) Manel Estoesta conducted unannounced Case Mangement Visit - Licensee Initiated. The Licensee / Applicant submitted an application for Capacity Increase and application received on 08/04/2022. LPA met with the Licensee / Applicant Xingxin Zheng and explained the nature of site visit. Present on this visit were the Licensee's Spouse, 2 infants and 4 preschool children. The home operates from Monday to Friday 8:30 am to 5 pm.

LPA received the approved STD 850 Fire Safety Inspection Request from Milpitas Fire Department on 08/17/2022 via email.

There are no deficiencies cited on this visit.

The home is recommended for a Large Family Child Care Home License effective today, 08/17/2022.



Exit interview conducted and report was reviewed with the Licensee, Xingxin Zheng.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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