434409734-2-4-2020-07-CC-SCOS-BLGUYZ-20200204150046

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409734
Report Date: 02/04/2020
Date Signed: 02/04/2020 03:00:51 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	THANG, NOEUN		FACILITY NUMBER:	434409734
ADMINISTRATOR:	NOEUN THANG		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 923-5850
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95116
CAPACITY:	14	CENSUS: 10	DATE:	02/04/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:03 PM
MET WITH:	Thang,Noeun		TIME COMPLETED:	03:20 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	On February 4, 2020 Licensing Program Analysts (LPA) Stephanie Collins conducted an annual inspection of the family day care home. LPA met with Licensee, Noeun Thang and explained the purpose of today's inspection. Upon LPAs’ arrival Assistant Husband Mao Seik was present in the home with ten (10) children in care. Licensee and assistant Mao Seik both have current Pediatric CPR/1ST Aid Certification, expiring 07/2021. Days and hours of operation are Monday through Friday from 06:00 AM – 6:30 PM. Licensee understands the capacity options and understands that the maximum capacity for a large family childcare home is 14 children. Licensee stated that she understands that when there is only one care provider present, the home must comply with the capacity of a Small Family Child Care Home License, which has a maximum capacity of eight. There are 4 adults who reside in the home the licensee her husband (Mao Seik) their son (Mao Sean) and their nephew (Thang Chanrith) and one other son under the age of 18yrs. A review of staff records on 2/3/2020 show that individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12-month period. Licensee has records showing proof of immunity against Measles and Pertussis. Licensee's AB1207 Mandated Reporter Training Certificate.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: THANG, NOEUN	FACILITY NUMBER: 434409734
	VISIT DATE: 02/04/2020

NARRATIVE

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LPA reviewed the roster of children in care and a copy was obtained. LPA reviewed sample of the children's files. Records reviewed include Parents' Rights, immunization, Emergency Contact Information, and Consent for Emergency Medical Treatment form.
LPA inspected the indoor and outdoor areas of the home. Smoke and Carbon monoxide detectors were tested and proved to be functioning. Fire and disaster drills were last conducted and recorded on 01/27/2020. LPA observed a fully charged fire extinguisher. The fireplace is screened and blocked . Medication, cleaning products and similar items that can pose a danger to children if readily accessible are stored inaccessible to children. Licensee states that there are no weapons in the home. The backyard is fenced, and by children . The home provides safe toys, play equipment and materials. Furniture and equipment are in good condition, free of sharp, loose or pointed parts.
Licensee states that currently she is not providing Incidental Medical Services. 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.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

Safe sleep information was reviewed with Licensee.

LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information.

No regulatory violations were observed during the inspection visit. Exit Interview was conducted, where this report was reviewed with Licensee. A copy of this report was given to Licensee.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie Collins	TELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

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