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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434407532
Report Date: 01/30/2020
Date Signed: 01/30/2020 11:05:25 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:DING, YANFACILITY NUMBER:
434407532
ADMINISTRATOR:DING, YANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 942-6911
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:14CENSUS: 10DATE:
01/30/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:DING, YANTIME COMPLETED:
11:20 AM
NARRATIVE
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On 01/30/2020 at 08:55 AM, Licensing Program Analyst (LPA) Manel Estoesta and Licensing Program Manager (LPM) Wynn Norona, met with licensee YAN DING for an UNANNOUNCED ANNUAL REQUIRED INSPECTION. Present for this visit were 3 infants and 7 preschool children, fingerprint cleared assistant JUNMIN YU and licensee's mother LILI YU. The home was toured for Health and Safety Inspection. The facility currently operates Monday to Friday from 8:00am to 06:30PM.

This is a 2 story home. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, family room, baby room, hallway bathroom, kitchen and the backyard. The OFF LIMIT AREAS are the whole second floor, 1 bedroom on the first floor, laundry room and the garage which will be inaccessible by closed and/or locked doors and visual supervision. There is a gate at the base of the staircase to prevent children accessing the second floor. The backyard is fenced. There are toys and learning materials in the facility. There are no pools, hot tubs or any other bodies of water present during the inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that during the inspection there are no toxins or hazardous items accessible.

The facility has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills at least every six months, the last fire drill was conducted on 12/20/2019. Licensee's Pediatric CPR and first aid certificates expired on 04/2019. Licensee stated that she will take the training again and will submit certificates to the licensing office. Licensee has current immunization records.



Licensee first language is Mandarin and will take the mandated reporter training until it is available in their language. Provided the website www.mandatedreporterca.com and advised that she need to take the General training and the Child Care Provider training.

****see LIC809C for continuation****
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
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 3
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: DING, YAN
FACILITY NUMBER: 434407532
VISIT DATE: 01/30/2020
NARRATIVE
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LPA obtained a copy of children's roster. The facility is in ratio today.

Individual Medical Services (IMS) policy was discussed. 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 licensee is reminded that any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility.

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

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

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.


Provided copies and discussed the Safe Sleep Flyer, Lead Poisoning Facts, Car Seat Law and a Blank Fire Disaster Drill log.

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

A copy of the appeal rights was provided.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: DING, YAN
FACILITY NUMBER: 434407532
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2020
Section Cited

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(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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This requirement was not met as evidenced by:
Based on file reviews licensees CPR /First Aid expired on April 2019. This poses a potential health and safety risk to children care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Manel EstoestaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3