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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410869
Report Date: 07/17/2019
Date Signed: 07/17/2019 04:59:40 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:OU, LIDANFACILITY NUMBER:
434410869
ADMINISTRATOR:OU, LIDANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 366-2607
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:14CENSUS: 14DATE:
07/17/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Lidan OuTIME COMPLETED:
05:05 PM
NARRATIVE
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Licensing Program Analyst (LPA), Marilou Monico, conducted a case management inspection. LPA met with Licensee, Lidan Ou, and explained the purpose of today's inspection. Also present in the home when LPA arrived were licensee's adult helper and 14 children including 12 preschool age and 2 children who are 5 years of age and enrolled in kindergarten. None of the children is at least 6 years of age.

LPA toured the home. LPA observed that three of the children who were present during the inspection were not listed on the children's roster. Licensee added the kids information on the children's roster.

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.

As a result of this inspection, deficiencies were cited on the following pages:

NOTICE OF SITE VISIT WAS ISSUE AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
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 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: OU, LIDAN
FACILITY NUMBER: 434410869
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/18/2019
Section Cited
CCR
102416.5(d)(2)
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STAFFING RATIO & CAPACITY - A large family day care home may provide care for more than 12 children and up to and including 14 children, if at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
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Licensee states that she will reduce her capacity. Licensee states she will submit a written plan to be within ratio at all times.
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This requirement is not met as evidenced by: LPA observed 14 children present in the home including 12 prechool age, 2 children who are 5 years old and enrolled in kindergarten, and none of them is at least six years of age. This poses an immediate risk to the health and safety to children in care.
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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
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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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: OU, LIDAN
FACILITY NUMBER: 434410869
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/17/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children. This requirement is not met as evidenced by: LPA observed that three of the children who were present during the inspection were not listed on the children's roster. This poses a potential risk to Health and Safety to children in care.
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Licensee added the kids information on the children's roster during the inspection. Copy of children's roster was obtained.

Deficiency corrected.
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Since this is a repeat violation within a 12 month period, an immediate civil penalty of $250.00 was assessed and $100 per day thereafter if not 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: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3