414003086-5-1-2019-05-CC-GASL-BBRUGV-20190501153458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414003086
Report Date: 05/01/2019
Date Signed: 05/01/2019 03:35:03 PM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	TRAN, ANDY N.		FACILITY NUMBER:	414003086
ADMINISTRATOR:	TRAN, ANDY N.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 281-1556
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94062
CAPACITY:	14	CENSUS: 11	DATE:	05/01/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Andy Tran		TIME COMPLETED:	03:45 PM

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 Analyst (LPA) Glenn Schnell conducted an annual random inspection which included a toured the home and yard, and a review of the required day-care forms with the licensee today. Present in the home is Licensee, Andy and his two helpers Martha and Mireya. Capacity and ratio requirements of children was observed in compliance today. This type of home is a single family home. Off limit rooms were identified as the entire upstairs of the home, and three bedrooms. There is one bedroom down the hall to the left that is used for napping infants. Adults living in the home are Andy, Linh, Kaitlyn, and three international students (this is a host home) Andy's two children under 18 also live in the home. A review of records indicates that all adults working or living in the home who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee owns the home. The daycare operates 7:30 AM to 5: 30 PM, Monday through Friday. Licensee has daycare insurance through DCI. LPA observed the following: -Stairs in the home are properly barricaded at top/bottom if caring for children under five years old. -Daycare area is clean, orderly, and equipped with age appropriate toys and equipment for the children. No baby walkers, bouncers, exercausers, etc. allowed to be used during day-care hours. -Home has proper lighting and ventilation. Home has a working telephone, a working smoke and carbon monoxide detector, and a fully charged 2A10BC fire extinguisher. -There are no bodies of water on the property. There is a fireplace in the daycare area of the home that is not used. The home has central heating. There are no detergents, or cleaning products accessible to day care children. Poisons are locked. Licensee states there are no guns or weapons of any kind in the home. The yard is fenced

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: TRAN, ANDY N.	FACILITY NUMBER: 414003086
	VISIT DATE: 05/01/2019

NARRATIVE

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-There are chickens that are kept in chicken coop that is not accessible to the children.
Licensee’s CPR and First Aid expires 2020. Emergency drills are conducted twice a year properly logged. Licensee provides daily snacks and meals. Discipline used is redirection. Isolation of sick children reviewed/discussed. Children’s roster was reviewed and is complete and up-to-date. Children and staff/helper files were reviewed and are complete. Supervision and transportation of children was discussed- no transportation provided. Capacity options were reviewed. Licensee understands that care cannot be provided for more than the capacity as stated on the license. Requirements for reporting suspected child abuse was discussed, as well as reporting requirements for unusual incidences. All required postings are properly posted (License/Parent’s Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist) Licensee has updated immunizations and Mandated Reporter Training on file. 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 as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.
Licensee was informed about the Provider Information Notices (PINs) on CCLD website.
Licensee was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com)
Licensee was advised of the upcoming changes to regulations regarding ‘Safe Sleep” and provided with handouts regarding “safe to sleep “ best practices.
This report and appeal rights were discussed with Licensee. This report must be available in the facility for public review. Notice of Site Visit was posted. Notice to remain posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

LIC809 (FAS) - (06/04)

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