013422807-12-11-2019-52-CC-BPLY-BJRSGU-20191211125230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422807
Report Date: 12/11/2019
Date Signed: 12/11/2019 12:52:37 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:	LIN, YANLING		FACILITY NUMBER:	013422807
ADMINISTRATOR:	LIN, YANLING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 829-8663
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	14	CENSUS:	DATE:	12/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:33 AM
MET WITH:	Yanling Lin		TIME COMPLETED:	01:00 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 12/11/19, Licensing Program Analyst Briana Plumboy, met with licensee Yanling Lin for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was licensees fingerprint clear husband Xiping Lin, licensee's fingerprint clear and associated son Dayong Lin, 1 infant, and 7 preschool age children. LPA Plumboy spoke with licensees son Dayong Lin for English to Mandarin and vice versa translation during the inspection. The children enter the family child care through a door located on the side of the home. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 8:00am until 6:30pm. The home is single story. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are: master bedroom, master bathroom, (2) additional bedrooms, kitchen, and laundry room closet area which will be inaccessible by a barrier gate / closed and/or locked doors and visual supervision. There is a gate located at the top of the stairs upon entrance to the children's playroom to separate the two levels. The ON LIMIT AREAS: the living room, dining room, children play room, hallway bathroom, and the backyard. The ISOLATION AREA will be the living room. There is a gate located between the dining room and kitchen to prevent access to the kitchen which is off limit. The BACKYARD play area is fenced. There is a garage located inside the backyard which is off limits and licensee is aware she must keep the door closed while children are in care. Licensee has a drinking fountain/water faucet located inside the backyard which drains into a bucket. Licensee is aware the bucket of water may not have any standing water. There are toys that appear to be safe and in good condition. There are no pools or hot tubs present today during the inspection. It was observed that there are no toxins or hazardous items accessible during the inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee CPR and First Aid certificate is current and expires 02/23/21. The licensee and her husband are in compliance with the immunization law pertaining to child care providers. Licensee currently has a waiver for the mandated reporter training until it is available in Mandarin. There is a wall heater located See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIN, YANLING	FACILITY NUMBER: 013422807
	VISIT DATE: 12/11/2019

NARRATIVE

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inside the play room which is screened with a fence to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted 11/15/19.
(4) Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
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 the ADA, available at: http://www.ada.gov/childqanda.htm

LPA Plumboy provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the licensee

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.

Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019

LIC809 (FAS) - (06/04)

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