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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404040
Report Date: 10/14/2021
Date Signed: 10/14/2021 04:19:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KUO, CHIA-JUNGFACILITY NUMBER:
434404040
ADMINISTRATOR:KUO, CHIA-JUNGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 323-1055
CITY:SAN JOSESTATE: CAZIP CODE:
95120
CAPACITY:14CENSUS: 0DATE:
10/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Chia-Jung KuoTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Oscar Huang met with Licensee, Chia-Jung Kuo for an unannounced annual/random inspection. LPA explained the nature of today’s inspection to Licensee. LPA observed no day care children in the home during today's inspection. Licensee stated that she only takes care after-school students and teaches Chinese lessen. Days and hours of operation are Monday to Friday, 3:30pm to 5:30pm for 2 hours except Wednesday 1:30pm to 3:30pm. The adults that reside in the home are Licensee and her husband. Licensee stated that due to the pandemic, she currently conducts the teaching via Zoom. Licensee stated that she will inform the department once she starts the in-person lessons.

Licensee Chia-Jung Kuo 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.

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: https://www.ada.gov/childqanda.htm



A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Chia-Jung Kuo.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
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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