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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422937
Report Date: 06/23/2020
Date Signed: 06/23/2020 11:51:41 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:FENG, DEMINFACILITY NUMBER:
013422937
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
06/23/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Demin FengTIME COMPLETED:
11:15 AM
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On 06/23/20 at 10:00am, Licensing Program Analyst (LPA) Briana Plumboy conducted an announced Case Management Inspection via Facetime with Licensee Demin Feng. Present for the inspection was two preschool age children in care as well as licensee's assistant/sister Dehui Feng. The home was virtually toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 7:30am to 6:00pm.

ON LIMITS: The living room, the dining room located off the living room, the hallway bathroom, the kitchen located through the sliding glass door and down two steps, and the backyard.

OFF LIMITS: The two bedrooms, one bathroom, the room situated within the garage, and garage.

The home is one level, which consists of two bedrooms, a room within the garage, two bathrooms, living room, dining room, backyard, and garage, which are neat and clean, with heating and ventilation for safety and comfort. The isolation area will be a section of the living room. There is a 2A10BC fire extinguisher, carbon monoxide detector, pull down fire alarm, and smoke detector which meet State Fire Marshall standards during today's inspection.
Per licensee, there are no firearms in the home. There are no pets in the home. All required licensing documents are posted and visible for public review. The licensee's Pediatric CPR/First Aid certificate is current and expires 09/14/2021. Licensee Demin Feng's Mandated Reporter training was completed on 11/19/2019. Licensee and Dehui Feng are in compliance with the immunization law.

See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2020
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: FENG, DEMIN
FACILITY NUMBER: 013422937
VISIT DATE: 06/23/2020
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On 02/28/20, a fire clearance was granted to facility #013422937 by Alameda County Fire Department. All documents have been received for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

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 .

As of 06/23/20, this home is recommended for an increase of capacity. There are no deficiencies cited today. The report will remain on file for three years. A notice of site visit was provided, and the licensee was reminded to have it posted for 30 days. An exit interview was conducted, and appeal rights provided.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2020
LIC809 (FAS) - (06/04)
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