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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075700208
Report Date: 11/15/2019
Date Signed: 11/15/2019 10:36:32 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:YING, JENNIFERFACILITY NUMBER:
075700208
ADMINISTRATOR:YING, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 456-5339
CITY:SAN RAMONSTATE: CAZIP CODE:
94583
CAPACITY:14CENSUS: 0DATE:
11/15/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Jennifer YingTIME COMPLETED:
10:50 AM
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Licensing Program Analysts (LPAs) Julia Placencia and Leslie Ibo arrived for an announced Prelicensing Inspection for a large family day care home, and met with the applicant Jennifer Ying. Applicant resides in the home with her fingerprint cleared spouse Chun Lin and two daughters, ages 8 and 12 years. The home was toured with the applicant to conduct a health and safety inspection. Applicant states the hours of operation for day care will be Monday through Friday, 6:30am to 6:30pm.

The home is single story, which consists of a kitchen, dining room, living room, three bedrooms, two bathrooms, garage, and a backyard which contains a locked storage unit. The home is neat and clean with heating and ventilation for safety and comfort.

ON LIMITS: Kitchen, dining room, living room, two bedrooms on the right of hallway, hallway bathroom, backyard. The isolation area will be the first bedroom on the right.

OFF LIMITS: Master bedroom/bath, garage, left side yard, storage unit in yard. All off limit areas will be inaccessible by closed and/or locked doors and visual supervision. The applicant was advised to contact Licensing, so that an inspection can be completed prior to changing an off limits area to on limits. Per the fire clearance, the garage is off limits to children.

The outdoor play area will be the backyard, which has a fence surrounding the perimeter of yard, and is free from defects or dangerous conditions. The off limits left side yard has a child safety gate in place. The applicant has two dogs. Per applicant, the dogs will be kept in the garage while children are playing outside. There are ample age appropriate toys which are observed to be safe, clean and in good repair. There are no pools, hot tubs or any other bodies of water. LPAs did not observe any hazardous materials or toxins accessible to children today. Knives were stored in a locked kitchen drawer, inaccessible to children.
***Continued on LIC809...
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: YING, JENNIFER
FACILITY NUMBER: 075700208
VISIT DATE: 11/15/2019
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 The home has a fully charged 2A10BC fire extinguisher which is attached to the wall in the kitchen, and working carbon monoxide/smoke detector combination units are throughout the home. Applicant also has a telephone and fully stocked First Aid Kit. The fireplace is screened, and inaccessible to children. Heater vents are located on the ceiling. Per applicant, there are no firearms in the home. The applicant’s health and safety training has been completed, and First Aid/CPR certificate is current, expiring on 3/22/20. A copy of the property tax bill has been reviewed and shows control of property. The applicant has provided proof of the required immunizations which pertains to child care providers, and the required mandated reporter training was completed on 10/12/18. A packet of forms pertaining to the children’s files and facility files were reviewed and discussed, and copies were left with the applicant. Safe Sleep practices were discussed, and new car seat laws were provided. Applicant was reminded that children are never to be left in a parked vehicle.

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.

The applicant was 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. The applicant was reminded of the responsibility as a mandated reporter.

Applicant 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.

The department received the approved fire clearance from the San Ramon Valley Fire Protection Department on 10/23/2019. As of today's date, 11/15/2019, licensee may begin operating as a Large Family Day Care.

Exit interview conducted with Jennifer Ying, and copy of report provided.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
LIC809 (FAS) - (06/04)
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