013420896-6-10-2021-02-CC-ASIH-C3UQ5J-20210610115202

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013420896
Report Date: 06/10/2021
Date Signed: 06/10/2021 11:52:08 AM

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	HAPPY LITTLE WORLD		FACILITY NUMBER:	013420896
ADMINISTRATOR:	LI, XIU HONG		FACILITY TYPE:	850
ADDRESS:	1214 OAK STREET, #A		TELEPHONE:	(510) 337-1830
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY:	20	CENSUS: 9	DATE:	06/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Xiu Hong Li		TIME COMPLETED:	12:20 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	On 06/10/2021 at 10:00 AM Licensing Program Analyst (LPA) Arminder Singh conducted an unannounced Annual/Random inspection at Happy Little World. LPA met with Licensee, Xiu Hong Li and explained the purpose of today's inspection. Facility’s License, Emergency Disaster Plan, Parents’ Rights Poster PUB393, Personal Rights, and Activity Schedules were observed to be posted. LPA did observe the facility does have appropriate COVID-19 postings. Facility's operating days and hours are Monday to Friday 8:00AM- 6:00PM . Licensee's daughter helped translate over the phone for the inspection purposes. At 10:45 AM the physical plant was inspected. LPA toured the premises with the Licensee. Indoor space: During today's inspection there were 9 children, Licensee and an assistant. Facility was observed to be in compliance with teacher to children ratio requirement during LPAs' inspection. The classroom, children's restroom, play area, and outdoor play area were inspected. There is a separate restroom for the staff. Breakfast, lunch and snacks are provided and prepared on site. The kitchen area was maintained in a clean manner and was inaccessible to children in care. Menus were posted. Waste containers have tight fitting lids. The sign in and out logs were reviewed. Children were engaged in various activities and under visual supervision of the Licensee and assistant. Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restroom for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Licensee stated that facility does not possess nor store any weapons on the premises. LPA observed a fully functional 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, and fire pull stations. Log shows that the last Fire Drill was conducted on 05/19/21. Facility does not provide transportation for children, but Licensee understands that children cannot be left alone, unattended in parked vehicles. There is a working telephone at the facility. CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HAPPY LITTLE WORLD	FACILITY NUMBER: 013420896
	VISIT DATE: 06/10/2021

NARRATIVE

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Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe . The play equipment was maintained in good condition and free of hazards. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities. The outdoor area does have shaded area for the children and there is a mat under the plastic slide to absorb a fall.

File Review: Children sign in and out procedures and logs were reviewed. A sampling of three (3) Children's files(c1-c3) files was reviewed. All child files contained Admission Agreement, Identification/Emergency Information, Consent for Medical Treatment, Immunization's, Parents rights, Personal rights.
All Staff files contained immunization and TB clearance records, Employee rights, Criminal Record Statement, transcripts. Licensee and assistant both have current CPR and First Aid certificate that expires on 03/02/2023. Children's Roster was reviewed.

Licensee stated that facility does not handle medications currently and does not have children in care who require Incidental Medical Services. Facility should submit IMS Plan with Oakland Regional Office. LPA reviewed storage of medication and equipment / supplies. Isolation of sick child was discussed, and Licensee explained that a sick child is brought to the Office Area to be isolated from other children. An adult restroom which is near the office is used for the isolation restroom. Child is always under visual supervision while being cared for.
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.

Beginning January 1, 2019 AB 2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. [Starting May 2019, both General Training followed by Child Care Providers Training is required to be taken]. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HAPPY LITTLE WORLD	FACILITY NUMBER: 013420896
	VISIT DATE: 06/10/2021

NARRATIVE

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LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person. LPA also reviewed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500.

Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

In the areas that were evaluated, no regulatory violations were observed.

At 11:45 AM Exit Interview was conducted, where this report was reviewed and discussed with Licensee. Report was signed by the Licensee confirming receipt of documents.

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

END OF REPORT

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021

LIC809 (FAS) - (06/04)

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