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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421827
Report Date: 04/12/2023
Date Signed: 04/12/2023 03:53:08 PM


Document Has Been Signed on 04/12/2023 03:53 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:ZHANG, FANG & SONG, JIEFACILITY NUMBER:
013421827
ADMINISTRATOR:ZHANG, FANG & SONG, JIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 575-4610
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY:14CENSUS: 11DATE:
04/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Jie SongTIME COMPLETED:
04:07 PM
NARRATIVE
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On Wednesday, April 12, 2023 at 1:35 PM, Licensing Program Analyst (LPA) Caroline Colson met today with Fang Zhang and Jie Song, Licensees, for an unannounced random annual inspection. There are ten preschool children and one infant present. The facility's operating hours are Monday - Friday from 8:00 AM to 5:00 PM. LPA toured the facility for a health and safety inspection.

Indoor Space: The home is a two story home. The home consists of one kitchen with dinning area, living room, 4 upstairs bedrooms, upstairs master bathroom, 1 upstairs bathroom, 1 downstairs bathroom, upstairs laundry area, fenced back yard and garage. The home has heating and ventilation for safety and comfort. The Isolation Area will be located near the front door. There is ample amount of toys available. Per Jie Song, there are no weapons in the home. All hazardous materials and toxins are stored away from children. The home is equipped with a 3A40BC fire extinguisher, working smoke detector and working carbon monoxide detector. Emergency Disaster Plan is current and posted. Licensees have current CPR and First Aid Training certificates which expire on July 10, 2023. Mandated Reporter Training certificates are current and expire on June 8, 2023. There are no pets.

Off Limit Areas: The master bedroom, master bathroom, one upstairs bedroom, one upstairs bathroom, laundry area and garage.

Outdoor Space: The outdoor play area is fenced. There are no pools, hot tubs or any other bodies of water on the premises.

Please See LIC 809 C for Additional Information.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHANG, FANG & SONG, JIE
FACILITY NUMBER: 013421827
VISIT DATE: 04/12/2023
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· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.



CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

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 ADA, available at: http://www.ada.gov/childquanda.htm

Licensee will send pictures of the new floor vents. Furthermore, pictures will be sent of the new location for diaper rash creams and baby wipes.

Please See LIC 809 C for Additional Information

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZHANG, FANG & SONG, JIE
FACILITY NUMBER: 013421827
VISIT DATE: 04/12/2023
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Family Child Care Homes

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Safe Sleep

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee, Fang Zhang and Jie Song 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.

Notice of Site Visit

A notice of site visit was given and must remain posted for 30 days.

Exit Interview

Exit interview conducted and report was reviewed with the licensee, Jie Song.

There were no deficiencies cited during this inspection.

SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 725-7008
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
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