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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423312
Report Date: 05/11/2023
Date Signed: 05/11/2023 09:58:42 AM


Document Has Been Signed on 05/11/2023 09:58 AM - 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:LEI, YUANYANFACILITY NUMBER:
013423312
ADMINISTRATOR:LEI, YUANYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 703-5938
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 6DATE:
05/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:34 AM
MET WITH:Yuanyan Lei- LicenseeTIME COMPLETED:
10:10 AM
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On 5/11/23 at 8:34am, Licensing Program Analyst Briana Plumboy met with licensee Yuanyan Lei for an UNANNOUNCED REQUIRED 1 YEAR INSPECTION. Present for this visit was licensees fingerprint clear and associated assistant Yuanchan Yu, 3 infants and 3 preschool age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 7:30am until 6:00pm.

The home is single story. The home consists of 4 bedrooms, 1 master bedroom with bathroom, 1 hallway bathroom, dining room, living room, family room, kitchen, laundry room, and garage. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the laundry room, kitchen, garage, 4 bedrooms, and master bedroom/bathroom which will be inaccessible by closed and/or locked doors and visual supervision. There are child safety gates located at the entrance of the family room, entrance of the living room, and 2 entrances to the kitchen. The ON LIMIT AREAS are the living room, family room, dining room, and hallway bathroom. The ISOLATION AREA will be the living room. Outdoor play area will be located inside the fenced backyard. There are toys and learning materials. There are no pools, hot tubs or any other bodies of water present at the facility during todays inspection. All hazardous materials and toxins were observed to be out of the reach of children during today's inspection. The licensee currently has valid day-care insurance. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires 02/11/25. The licensee is aware when the mandated reporter training is available in Mandarin, she must complete the training and obtain a certificate. The licensee and assistant Yuanchan Yu are in compliance with the immunization law. The fireplace is located inside the living room and is covered 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 on 01/4/23.

A copy of the roster was reviewed and a copy was obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. 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: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
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: LEI, YUANYAN
FACILITY NUMBER: 013423312
VISIT DATE: 05/11/2023
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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 Yuanyan Lei 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 Yuanyan Lei 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 Yuanyan Lei.

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

DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023
LIC809 (FAS) - (06/04)
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