013419949-9-5-2019-52-CC-MOTI-BFQQR4-20190905122319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013419949
Report Date: 09/05/2019
Date Signed: 09/05/2019 12:23:28 PM

COMPREHENSIVE INSPECTION

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:	ZHANG, WEI		FACILITY NUMBER:	013419949
ADMINISTRATOR:	ZHANG, WEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 552-3035
CITY:	FREMONT	STATE: CA	ZIP CODE:	94539
CAPACITY:	14	CENSUS: 7	DATE:	09/05/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	09:03 AM
MET WITH:	Wei Zhang		TIME COMPLETED:	12:43 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) Melanie Otsuji, met with licensee Wei Zhang for an UNANNOUNCED ANNUAL REQUIRED INSPECTION. Present for this visit was assistant Huali Lin, and 7 children (1 infant, 6 preschoolers). The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday - Friday from 8:30AM to 6:30PM. The home is a single story home. The home appears to be neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the family room, backyard, bathroom, nap room, and all bedrooms. The OFF LIMIT AREAS are the garage, kitchen, right side of the yard, master bathroom which are inaccessible to children by closed and/or locked doors and visual supervision. The BACKYARD play area is fenced. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies of water present during the inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that during the inspection there are no toxins or hazardous items accessible. The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. Both the licensee and assistant have current Pediatric CPR/First Aid. The facility last conducted an earthquake and fire drill on 8/19/2019. Facility maintains current individual records for each child enrolled. Additionally, facility utilizes sign in/out sheet per stipulation. Facility has current liability insurance affidavit on file for each child enrolled. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

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: ZHANG, WEI	FACILITY NUMBER: 013419949
	VISIT DATE: 09/05/2019

NARRATIVE

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The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.

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 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

No deficiencies are cited on today's date. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

LIC809 (FAS) - (06/04)

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