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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423434
Report Date: 12/22/2022
Date Signed: 12/22/2022 10:41:21 AM


Document Has Been Signed on 12/22/2022 10:41 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:JUNG, LINDAFACILITY NUMBER:
013423434
ADMINISTRATOR:MODLIN, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 750-7680
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:14CENSUS: 7DATE:
12/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Linda JungTIME COMPLETED:
11:00 AM
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On December 22, 2022, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux, met with Licensee Linda Jung for an UNANNOUNCED ANNUAL REQUIRED INSPECTION. Present for the inspection was Licensee Linda Jung, finger print cleared and TB cleared staff Katelyn Marin. The home was toured to conduct a Health and Safety Inspection hours of operation are Monday - Friday 6:30 AM - 5:30 PM. The licensee is within ratio today. Age range of care 2.5 years to school age. (No Infants)

The home is a single story home with 4 of bedrooms, 2 bathrooms, living room, family room, kitchen with dinning area, laundry room, garage, 3 sheds back yard with locks. The home appears to be neat and clean with central heating and ventilation for safety and comfort. The home does have a fireplace in the living room that is screened to prevent access to children.

The ON-LIMIT AREAS are family room/living and dining room. The backyard will be a designated outdoor play area that is fully fenced. The OFF-LIMIT AREAS are all bedrooms and master bedroom bathroom and will be inaccessible to children by locked doors, safety gates and visual supervision. Isolation Area is in the office away from the children in care, until the parents arrive.

The outdoor area has age appropriate toys that appear to be clean and free from defects and dangerous conditions. There are no pools, hot tubes or any other bodies of water. All hazardous materials and toxins are kept out of reach from children and are not accessible. The home has a fully charged fire extinguisher 3A40BC located in the kitchen, pull down fire alarm, working smoke detector, carbon monoxide (tested), working telephone and fully stocked first aid kit. Per licensee, there are no firearms on the premises.

The licensee completed the Health and Safety training, CPR/First Aid is current and expires on 01/16/2023. The licensee has the immunization laws and has completed the mandated reporter training. Discussed with licensee it must be renewed every two years. The licensee conducts and documents fire and disaster drills twice a year last one was on 06/30/2022. Facility roster reviewed and copy obtained. All required forms are posted and visible for public review.

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

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2022
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: JUNG, LINDA
FACILITY NUMBER: 013423434
VISIT DATE: 12/22/2022
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Incidental Medical Services (IMS) policy was discussed. Per director, currently there are no children on medication. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 [or facility representative] 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.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

California Law requires Family Childcare 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 for (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail and the written report (LIC 624) must be submitted within 7 business days.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022
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: JUNG, LINDA
FACILITY NUMBER: 013423434
VISIT DATE: 12/22/2022
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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.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the licensee [or facility representative] Linda Jung.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022
LIC809 (FAS) - (06/04)
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