013422693-1-15-2020-02-CC-CCON-BKUVKA-20200115153001

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422693
Report Date: 01/15/2020
Date Signed: 01/15/2020 03:30:12 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	FU, HANPING		FACILITY NUMBER:	013422693
ADMINISTRATOR:	FU, HANPING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 328-0332
CITY:	ALBANY	STATE: CA	ZIP CODE:	94706
CAPACITY:	14	CENSUS: 10	DATE:	01/15/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:06 PM
MET WITH:	Hanping Fu		TIME COMPLETED:	03:50 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 Caroline Colson met with Hanping Fu and her husband Li Fu Li for an unannounced random annual inspection at 2:00 PM. There are 8 preschool children and 2 infants present. One child's record was reviewed by the LPA and the licensee on 1/15/2020 at 3:00 PM. C1 has immunization records available in the file. The home was toured to conduct a health and safety inspection. The home is a one story home. The home consists of a living room, kitchen, four bedrooms, one bathroom, unfenced front yard, fenced back yard, fenced side yard and garage. The off limit areas are 3 bedrooms, fenced side yard and the garage. Mrs. Fu will use her fenced back yard for outdoor play. The home has a 2A10BC fire extinguisher, a working smoke detector and working carbon monoxide detector. There is heat in the home. All wall heaters are properly screened. Mrs. Fu states there are no firearms in the home. The living room is the isolation room. There are gates blocking the entrance of the living room and second bedroom. Older children are able to unlock these gates. She conducts fire/disaster drills every six month. Her infant CPR and First Aid certificates are current and expire on January 13, 2021. She has a first aid kit. There is one rabbit and one chicken. This facility is not providing Incidental Medical Services - IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417. Please LIC 809 C for additional information

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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: FU, HANPING	FACILITY NUMBER: 013422693
	VISIT DATE: 01/15/2020

NARRATIVE

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REMINDERS/RESOURCES

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident.

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· 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

All immunization records will be sent to our department within 30 days. There are a few items that need to be stored in the side yard or garage.

There were no deficiencies cited during this inspection.

Notice of site visit was posted at the time of the inspection and must be posted for 30 days. An exit interview was conducted. Appeal rights were given and discussed. This report must be available for public review for 3 years.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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