015700121-7-14-2021-52-CC-RRED-C4WNXL-20210714105120

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700121
Report Date: 07/14/2021
Date Signed: 07/14/2021 10:51:32 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:	HUANG, QING		FACILITY NUMBER:	015700121
ADMINISTRATOR:	HUANG, QING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 876-7513
CITY:	DUBLIN	STATE: CA	ZIP CODE:	94568
CAPACITY:	14	CENSUS:	DATE:	07/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Qing Huang		TIME COMPLETED:	11:00 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	Licensing Program Analysts, (LPA), Renee Reed met with Licensee Qing Huang on 7/14/2021 at approximately 9:00 AM for an UNANNOUNCED 1 YEAR REQUIRED INSPECTION. Present during this inspection was Licensee and licensee's infant daughter. Licensee currently has no children in care and has not had children in care since she has moved to this location. LPA and Licensee toured the home to conduct a Health and Safety Inspection. The facility currently operates 8:30 AM to 5:30 PM., Monday through Friday. The home is neat and clean with heating and ventilation for safety and comfort. Description of Home: The residence is a two story; which consist of 4 bedrooms, 2.5 bathrooms. As you enter, there is a gate at front with a courtyard leading to the front door. Living room converted to childcare room, dining/family room combo converted to childcare room, kitchen and attached garage. Off Limit Areas: 1st floor kitchen area, entire upstairs level, and garage. The off-limit areas was inaccessible by child safety gates, closed and/or locked doors and visual supervision. On Limit Areas: 1st floor area on limits to children in care, which consist of living room, family/dining room area that has been converted to a playroom a 1/12 bathroom to the left side of home entering, as well as the backyard. Isolation area: family/dining room area converted to childcare room. The stairway has child safety gating at the base of the stairs. There is a fireplace which is covered to prevent access by children in care. During inspection LPA observed there are multiple smoke detectors and a carbon monoxide detector present and working. The facility has a fully charged 3A40BC fire extinguisher. There are age appropriate furnishings, toys and equipment in the childcare rooms. The bathroom has working toilet and faucet in good working condition. Per Licensee, there are no firearms located or stored on the premises. See 809-C

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

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: HUANG, QING	FACILITY NUMBER: 015700121
	VISIT DATE: 07/14/2021

NARRATIVE

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The facility has a fully fenced back yard area. There are no pools, hot tubs or other accessible bodies of water. There are age appropriate toys and equipment in the backyard. Hazardous items/cleaning supplies are stored inaccessible to children in care. All electrical outlets are safety outlets.

The Licensee’s CPR and First Aid certificate has expired 03-02-2021. LPA advised licensee to renew CPR and First Aid before she reopens, which Licensee stated she plans to re-open December 2021 or by January 2022. LPA advised Licensee once CPR and First Aid is complete to submit a copy to LPA by email.

The Licensee’s completed and received a certificate in mandated reporter training on 04-02-2020 and expires 4/2/.2022 The Licensee is following the immunization laws which pertains to all day care providers. No files were reviewed as Licensee stated she has not had children in care since she was licensed at this home in July 2020.

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.

LPA Reed reminded the Licensee of the following; Mandated Reporter training is to be renewed every two years; CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

The Licensee is also reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

LPA Reed provided Licensee a copy of LIC 9227 Individual Infant Sleep plan and discussed requirements for safe sleep.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list
There is no deficiencies cited today.

A copy of this report was provided and to remain in facility records for a period of three years. A notice of site visit provided and must be posted in the facility for 30 days. Appeal Rights also provide. Exit interview conducted. .

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Renee Reed	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

LIC809 (FAS) - (06/04)

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