434412272-6-27-2019-07-CC-YHUG-BDJRVK-20190627132137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434412272
Report Date: 06/27/2019
Date Signed: 06/27/2019 01:21:43 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:	JIANG, BILI & HAN, GUANGXUE		FACILITY NUMBER:	434412272
ADMINISTRATOR:	BILI & GUANGXUE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 207-7413
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95131
CAPACITY:	14	CENSUS: 10	DATE:	06/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Guangxue Han		TIME COMPLETED:	11:50 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) Oscar Huang met with Co-Licensee Guangxue Han for an unannounced annual/random inspection. LPA explained the nature of today’s inspection to Licensee. LPA also observed two adult assistants and 10 day care children (3 infants and 7 preschoolers) in the home during today's inspection. Days and hours of operation are Monday to Friday, 8:00am to 6:30pm. The adults that reside in the home are Licensee, his adult son & nephew and his nephew's daughter-in-law. Her nephew's two 15 & 7 years old daughters also live in home. LPA advised licensee that the 7 years old child will be accounted in his capacity when present. Licensee requested his wife name to be removed from the license as she has passed away. LPA advised licensee to submit CCL an application with update. A review of staff records on today indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also 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 understands upon notice of the Department to remove an individual from the home, or to exclude an individual from the home, Licensee shall immediately remove the individual and prevent them from returning to the home or having contact with children in care. LPA toured the indoor and outdoor areas of the home during today’s inspection. LPA observed that the home is clean and orderly, with heating and ventilation for safety and comfort of the children. LPA observed no stairs inside the home. The main area of the home is used for the day care are living room, family room, bedroom 3 & 4 and a bathroom. LPA observed a barricaded fireplace. LPA observed safe and sufficient materials, toys, and play equipment for the day care children. All sharp objects, detergents, cleaning compounds, medications, poisons, and other similar items are stored inaccessible to children. LPA observed a fully charged 3A40BC fire extinguisher, a combined working smoke detector/carbon monoxide detector. Licensee states there are no weapons/firearms in the home. Off limit areas indoor: bedroom 1 & 2, kitchen, and the garage. LPA observed a fenced backyard and no bodies of water. LPA observed a locked storage shed in the fenced off area. Off limit areas outside the home: both side yards and the right backyard where the storage shed is. Licensee owns the house, and has child care liability insurance with United States Liability Insurance. Facility Evaluation Report dated 06/27/2019 to be continued on next page:

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

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

FACILITY NAME: JIANG, BILI & HAN, GUANGXUE	FACILITY NUMBER: 434412272
	VISIT DATE: 06/27/2019

NARRATIVE

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Facility Evaluation Report dated 06/27/2019 to be continued from previous page:
LPA observed Licensee has current CPR and First Aid certification expiring 01/29/2020. LPA observed a current roster of the children and a fire and disaster drills log which is to be done at least once every six months. The last drills were conducted on 01/08/2019. LPA reviewed 10 children files including Immunization records are maintained and up-to-date, and Notification of Parents’ Rights is in each child’s file.

Supervision of children was discussed with Licensee, and he understands that he must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands his capacity options. Licensee states that he does not transport children via vehicle but he understands that children cannot be left in parked vehicles unattended at any time. LPA reviewed safe sleep policies for the infants with the Licensee and provided Licensee "A Child Care Provider's Guide to Safe Sleep” document. More information can be founded at http://www.cdss.ca.gov/inforesources/Child-Care-Licensing.

LPA discussed AB 2231: Civil Penalty Updates effective July 1, 2017 with Licensee. A $500 immediate civil penalty and $100 per day violation until corrected is assessed for serious violations such as absence of supervision, accessible bodies of water, accessible firearms, refused entry of licensing staff, presence of an excluded person, and violations that result in illness or injury. A $100 per day for each violation for Failure to Correct, and $250 immediately and $100 per day per violation until corrected for Repeat Violations. LPA discussed SB 792 Immunization Requirement with Licensee. LPA observed appropriate records for immunizations against measles, pertussis, and influenza for Licensee but not for the assistants in file. Incidental Medical Services (IMS) were discussed with Licensee. Licensee is not providing IMS at this time. 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.htmLicensee will submit a plan of operation for IMS if in the future they provide any IMS to a child in care.

LPA discussed Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. The training web site is available at: http://www.mandatedreporterca.com/, LPA did not observe licensee's training certificate. His two assistants requested to be exempted from training until a Chinese version becomes available.
Deficiency was cited. Deficiency, Plan of Correction, and Appeal Right discussed with Licensee. Appeal Right provided to Licensee. Exit interview conducted with Licensee. A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

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: JIANG, BILI & HAN, GUANGXUE	FACILITY NUMBER: 434412272
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/27/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/11/2019 Section Cited HSC 1596.8662(b)	1 2 3 4 5 6 7	A licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training. This requirement was not met as evidenced by: LPA did not observe licensee's training certification. This poses a potential safety & health risk to children in care.	1 2 3 4 5 6 7	Licensee to complete his training and send copy of the certifiication to CCL by the POC due date.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC809 (FAS) - (06/04)

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