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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419648
Report Date: 01/16/2024
Date Signed: 01/16/2024 01:46:50 PM


Document Has Been Signed on 01/16/2024 01:46 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:HSIEH, CHUN HWA & MENG, WEI TEFACILITY NUMBER:
013419648
ADMINISTRATOR:HSIEH, CHUN HWA & MENG, WEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 661-9868
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY:14CENSUS: 8DATE:
01/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Wei Te MengTIME COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced on today's date, 1/16/2024, to conduct a Required - 3 Year inspection. LPA was met by Licensee Chun Hwa Hsieh with Licensee Wei Te Meng arriving shortly thereafter. Also present during today's visit were 2 additional staff members and 8 preschool aged children. LPA conducted a health and safety inspection inside and outside.

ON LIMIT AREAS: Two classrooms nearest the front door, dining area, bathroom nearest the family room, family room, and backyard play area.


OFF LIMIT AREAS: All bedrooms, kitchen, and garage.

There are no pools, spas, or similar bodies of water on the premises. Per Licensee, there are no firearms on the premises. Storage areas for poisons are inaccessible. Detergents and other cleaning compounds that can pose a danger to children are stored where inaccessible. A fully charged fire extinguisher was observed. Carbon monoxide and smoke detectors were observed. The home is kept clean, and orderly with ventilation for safety and comfort. LPA observed safe toys, play equipment and materials. The home has a working telephone on site. Outdoor play areas are fenced and supervision is provided while children are outside. On today's date, Licensee was within the proper capacity for their large family child care home license. All individuals present during today's date had the proper criminal record clearance. Each child's file contained the appropriate documentation.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HSIEH, CHUN HWA & MENG, WEI TE
FACILITY NUMBER: 013419648
VISIT DATE: 01/16/2024
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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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/.
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, Wei Te Meng, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.
No citations found on today's date, 1/16/2024.
Exit interview conducted and report was reviewed with the licensee Wei Te Meng.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC809 (FAS) - (06/04)
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