013421827-10-28-2021-02-CC-MMEA-C8G4DY-20211104190129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013421827
Report Date: 10/28/2021
Date Signed: 10/28/2021 11:50:12 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/11/2021 and conducted by Evaluator Caroline Colson

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20211011092313

FACILITY NAME:	ZHANG, FANG & SONG, JIE		FACILITY NUMBER:	013421827
ADMINISTRATOR:	ZHANG, FANG & SONG, JIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 575-4610
CITY:	ALBANY	STATE: CA	ZIP CODE:	94706
CAPACITY:	14	CENSUS: 6	DATE:	10/28/2021
		ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Fang Zhang		TIME COMPLETED:	11:50 AM

ALLEGATION(S):

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Other - Licensee did not prevent the spread of illness

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Caroline Colson met with Fang Zhang, and her husband, Jie Song for a virtual announced complaint investigation at 9:30 AM. There are five (5) preschool children and one (1) infant present. An allegation was made that the licensee did not prevent the spread of an illness. Interviews were conducted. There was one child who had symptoms over the first weekend in October. An interview revealed that the child did come to the facility on that following Monday but was only absent on Tuesday and Wednesday. The child arrived back to the facility on Thursday and start exhibiting symptoms during the day. Licensee didn't ask for a doctor's note to ensure the child could come back to the facility. During the same week, an additional three (3) children developed symptoms. Based on LPA's interviews which were conducted and a record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 102417 (e) is being cited on the attached LIC 9099 D.

The attached type B deficiency is being cited today and must be corrected by the due date. An exit interview was conducted. Appeal rights were given and discussed. This report must be available for public review for 3 years.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20211011092313

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ZHANG, FANG & SONG, JIE	FACILITY NUMBER: 013421827
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/28/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/11/2021 Section Cited CCR 102417(e)	1 2 3 4 5 6 7	Operation of a Family Child Care Home When a child shows signs of illness he/she shall be separated from other children and the nature of the illness determined. If it is a communicable disease he/she shall be separated from other children until the infectious stage is over.	1 2 3 4 5 6 7	Licensee will need to update her illness/sick policy to ensure the health and safety of all children in care. Licensee stated that she will be requiring a doctor's note before a child can return from being sick.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by document review and licensee interview. There was a child who was allowed to come to the facility with symptoms. Licensee did not separate the child until the infectious stage was over. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat violations are 250.00 per violation and $100.00 per day until corrected.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC9099 (FAS) - (06/04)

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