013417809-10-6-2023-52-CC-LDBX-CWCRE3-20231006125653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013417809
Report Date: 10/06/2023
Date Signed: 10/06/2023 12:56:59 PM

Document Has Been Signed on 10/06/2023 12:56 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	LIU, YINGNIAN		FACILITY NUMBER:	013417809
ADMINISTRATOR:	LIU, YINGNIAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 461-1776
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94566
CAPACITY:	14	CENSUS: 0	DATE:	10/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Yingnian Liu		TIME COMPLETED:	01:20 PM

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On October 6, 2023, Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux and Brittany Crass met with licensee Yingnian Liu for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. There were no children present during the inspection. Licensee stated that the facility operates from Monday to Friday 11:30 AM - 6:30PM. (only provide care for after school care)

This is a two story home with 5 bedrooms and 4 bathrooms. LPA toured the facility inside and outside to conduct a Health and Safety inspection. This home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. The Isolation area of the home will be a section of the family room, away from other children in care. Per request of the licensee added the first floor bedroom from off limits to on limits effective today 10/06/23.

On-limit-areas are the: Living and dining room, family room, kitchen, bathroom on the main floor, hallway, one bedroom on the main floor next to the bathroom and backyard.

Off-limit-areas are the: All bedrooms up stairs (4 bedrooms and 3 bathrooms), entire second level of home, laundry room, right and left side-yard and garage.

The off-limits area will be made inaccessible by closed and/or locked doors and visual supervision. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. There are no pools, hot tubs or any other bodies of water present in the on-limit areas during today's inspection.

The home has a working smoke detector, working carbon monoxide detector, first aid kit, telephone, and fully charged 3A40BC fire extinguisher located in the kitchen. Per licensee, there are no firearms in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers. Per licensee she does transport children usually walks when the weather permits.

See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIU, YINGNIAN	FACILITY NUMBER: 013417809
	VISIT DATE: 10/06/2023

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OUTDOOR PLAY area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, there are no play structures which are required to be anchored. Licensee was reminded to keep all tools and sharp equipment out of the yard when children are present.

At 11:45 AM LPA requested and reviewed the files of one (1) children in care. All children’s files contain Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtained. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 05/12/23. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 12/18/2023. The licensee completed mandated reporter training on 02/10/2023. The licensee is in compliance with the immunization laws which pertain to all childcare providers. All required forms are posted and visible for public review.

Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

See LIC 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIU, YINGNIAN	FACILITY NUMBER: 013417809
	VISIT DATE: 10/06/2023

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Yingnian Liu, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the licensee Yingnian Liu..

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC809 (FAS) - (06/04)

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