013422807-12-8-2021-52-CC-BPLY-C9HQRM-20211208112409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422807
Report Date: 12/08/2021
Date Signed: 12/08/2021 11:24:17 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 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: 5	DATE:	12/08/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	Yanling Lin- Licensee		TIME COMPLETED:	11:40 AM

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 12/8/21 at 10:13am, 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, licensee's fingerprint clear and associated daughter Jiedan Lin, and 5 preschool age children. LPA Plumboy spoke with licensees daughter Jiedan 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 and the children play on the cement area in the backyard only. The garden area in the backyard is off limit to children in care. 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 during today's inspection. 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 04/25/23. The licensee and her husband are in 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: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: LIN, YANLING	FACILITY NUMBER: 013422807
	VISIT DATE: 12/08/2021

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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 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 09/06/21. 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. 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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, 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

LPA discussed the safe sleep regulations with licensee Yanling Lin and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Yanling Lin 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.

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

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Yanling Lin.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

LIC809 (FAS) - (06/04)

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