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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420709
Report Date: 06/25/2021
Date Signed: 06/25/2021 12:27:45 PM

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:NG, MUILAMFACILITY NUMBER:
013420709
ADMINISTRATOR:NG, MUILAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 706-8378
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 5DATE:
06/25/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Muilam Ng and Weiqi MeiTIME COMPLETED:
12:40 PM
NARRATIVE
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On June 25, 2021 at approximately 8:30 pm Licensing Program Analyst (LPA) Russ Haderer met with licensee Muilam Ng (and her assistant Weiqi Mei for the purpose of conducting an unannounced 1-Year Required inspection for Health and Safety compliance. Upon arrival it was found that live-in assistant Weiqi Mei was not associated to the facility, however, she is fingerprint cleared through TrustLine and with help from the Oakland office, LPA associated her to the facility on-site. TB clearance was also observed for Weiqi Mei..

Present for the inspection were licensee Muilam, his wife Suichi Wong, their assistant Weiqi Mei and 3 children in care, two additional children arrived during the visit. Children's ages are: 3 infants and two toddlers, the home is in ratio today. Hours of operation are M-F 8:30 am to 6:00 pm.

The family only speaks Cantonese. LPA was prepared to use the CTS Language Link, however, helper Weiqi Mei was available to help interpret and assist the LPA during the inspection.

The facility is a single-story home consisting of a kitchen, living room, family room, four bedrooms, one bathroom, an attached two-car garage and an enclosed/fenced private backyard. The home had an addition in 2007 to the family room (not on facility sketch), with a sliding glass door that leads the three separate off-limits spaces. The home is neat and clean, with heating and ventilation for safety and comfort. LPA did not observe any hazardous materials or toxins accessible to children today.

ON LIMITS area includes the living room, family room, and main house bathroom at the end of the hall,
OFF LIMITS areas include all four bedrooms, kitchen, attached two-car garage, room addition off the family room and outdoor backyard area,

Continued on Page 2..........................
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
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 6
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: NG, MUILAM
FACILITY NUMBER: 013420709
VISIT DATE: 06/25/2021
NARRATIVE
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Upon entering, LPA noticed Required postings were not all present. Posted items included were the License, and Parent’s rights poster, missing was the Emergency Disaster Plan, the Earthquake preparedness checklist and the Child Passenger Safety Law posters. Licensee located Emergency Disaster Plan in the files posted it with the Earthquake checklist. LPA provided a copy of the seatbelt laws poster.


Fire/disaster drill log was available showing the last drill conducted on May 2021. The home has a fully charged 2A10BC fire extinguisher mounted in the family room. The home has working fire alarms (tested) and a working carbon monoxide detector (tested).The fireplace in the home has been removed and a window has been added in its place.

The facility did not have a child roster available and records were not available for all children. Records were available for 3 of the five children in care. The two without records started in late May 2021. The licensee does not have liability insurance, form LIC 282 was signed by each parent and in the children's file.

LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection. There are age appropriate toys, learning materials, and equipment that appear to be safe and in good condition.

The licensee's Health and Safety training is completed, and CPR and First Aid certificate expired on July 28, 2020. PIN 21-07 provided and Technical Advisory issued to renew these asap. Licensee does not have mandated reporter training done until it becomes available in Cantonese language.

The licensee, and his wife who resides in the home, are both in compliance with TB immunization with negative results. The licensee is up to date with the immunization laws which pertains to day care providers. Records were present showing Tdap and MMR immunization .
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: NG, MUILAM
FACILITY NUMBER: 013420709
VISIT DATE: 06/25/2021
NARRATIVE
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Per licensee, there are no firearms in the home.

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.

Individual Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

LPA reminded the licensee that CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

There were deficiencies found today. Please refer to LIC 809D .

This report will remain on file for 3 years. A Notice of Site Visit was posted at time of inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: NG, MUILAM
FACILITY NUMBER: 013420709
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2021
Section Cited

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1596.867 Disaster plan; earthquake preparedness checklist; construction of section
(a)....All child day care facilities...shall include an Earthquake Preparedness Checklist as an attachment to the disaster plan....
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The Earthquake Preparedness Checklist shall be made accessible to the public at the child day care center, or family day care home.
Based on observation and interview, the
licensee did not have required postings which poses a health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 06/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/25/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: NG, MUILAM
FACILITY NUMBER: 013420709
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2021
Section Cited

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102417 Operation of a Family Child Care Home
(g)(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
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This requirement is not met as evidenced by:
Based on observation, facility does not have an updated children's roster, which poses a potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 06/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/25/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: NG, MUILAM
FACILITY NUMBER: 013420709
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2021
Section Cited

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102421 Child's Records
(a)(b)(c)(d)(e)
The facility shall maintain children's records
This was not evidenced as there were no files for two recently admitted children in care which poses a potential risk to children in care
Type B
06/25/2021
Section Cited

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102419 Admission Procedures and Parental and Authorized Representative's Rights
The facility shall maintain children's records.
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This was not evidenced as there were no files for two recently admitted children in care which poses a potential risk to children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 06/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/25/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6