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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423145
Report Date: 04/27/2023
Date Signed: 04/27/2023 03:49:55 PM


Document Has Been Signed on 04/27/2023 03:49 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:JIANG, WENDONGFACILITY NUMBER:
013423145
ADMINISTRATOR:JIANG, WENDONGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 918-3888
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 8DATE:
04/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Wendong JiangTIME COMPLETED:
04:00 PM
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On April 27, 2023 at approximately 1:45pm Licensing Program Analyst (LPA) Haderer arrived and met with the licensee Wendong Jiang for the purpose of conducting an unannounced 1-year annual inspection for Health & Safety. Present for today’s inspection was the licensee, her daughter Hang Su, one helper and 8 children in care (4 infants; 4 two-years old). The facility is in ratio today. Hours of operation are Monday-Friday 8:30am 6:00pm.

The facility is a single-story home with 4 bedrooms; 3 bathrooms; living room (day care area); family room (day care area); dining room; kitchen; attached 2-car garage; front, back and side yards. There is no fireplace in the home. The home has heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the living room (day care area) or child’s napping room away from the other children in care. All required postings are present.

ON LIMIT AREAS: Living room; family room; house bathroom on the right side of the hall; hallway leading to the house bathroom and child napping room on the left side of the hall; and enclosed patio area with a sturdy fence to keep children from leaving the area. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products.



OFF LIMIT AREAS: Remaining 3 bedrooms in the home; 2 master bathrooms; kitchen; dining room; attached 2-car garage; and backyard areas outside of the fenced in children’s area on the patio. The off-limit areas will be inaccessible by child gates, closed and/or locked doors and adult supervision.

The home has a fully charged 2A10BC fire extinguisher mounted on the wall in the kitchen, smoke and carbon monoxide detectors (tested and working) and a working telephone. Fire drills are conducted at least once every 6 months, the last drill was completed in January 23, 2023. Licensee has a fire arm kept in a locked in a gun safe, ammunition is stored separately.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: JIANG, WENDONG
FACILITY NUMBER: 013423145
VISIT DATE: 04/27/2023
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Licensee has ample age-appropriate toys and learning materials inside and outside the home. The outdoor play area is free from defects and dangerous conditions. Drop-down cribs are not allowed at the day-care facility. Toxins, medicines, and hazardous items were inaccessible during today's inspection.

LPA reviewed facility files including records for licensee and Children’s files. The facility roster was reviewed, and a copy obtained. Children’s files were complete and well organized. For infants in care, sleep logs are maintained through Daily Connect App, checked and verified. The licensee owns the property and has liability insurance provided by Accord (D&C Insurance Solutions) effective through 10/01/2023.

Licensee required has immunizations. CPR/1st Aid was available for licensee, expires 9/25/2023. Mandated Reporter was completed on 6/12/2021. Licensee was reminded that CPR/1st Aide and Mandated Reporter is to be renewed every two years.

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

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.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: JIANG, WENDONG
FACILITY NUMBER: 013423145
VISIT DATE: 04/27/2023
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LPA discussed the safe sleep regulations with licensee 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 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There were no deficiencies issued today. The report will remain on file for three years.

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



Exit interview conducted and report was reviewed with the licensee Wendong Jiang and Hang Su.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
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