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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434412621
Report Date: 07/16/2019
Date Signed: 07/16/2019 12:26:26 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:CHUANG, STEPHANIEFACILITY NUMBER:
434412621
ADMINISTRATOR:STEPHANIE CHUANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 253-8219
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:14CENSUS: 5DATE:
07/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:07 AM
MET WITH:Stephanie ChuangTIME COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Marilou Monico and Nancy Rodriguez, made an unannounced annual random inspection. LPAs met with Licensee, Stephanie Chuang, and explained the nature of today's visit. Also present in the home were five preschool age children. Days and hours of operation are Monday to Friday from 8:30 AM to 5:30 PM. There are three adults residing in the home: licensee, her husband, and her son.

LPAs toured the home both indoor and outdoor. LPAs observed sufficient materials, toys, and play equipment for the day care children. The home is clean. There is a fully charged 3A40BC fire extinguisher, working smoke detector, functioning carbon monoxide detector, and no bodies of water. Off limit areas in the home: bedrooms 1, 2 and 3, bathroom 2, and the garage. Off limit areas outside the home: storage shed. Medications, cleaning compounds, sharp objects, and other similar items are stored out of reach of children. Per licensee, there are no weapons in the home. Five children's files were reviewed. Licensee maintains a current children's roster. LPA obtained copy of children's roster. Fire drill was last conducted on December 19, 2018. Licensee has current CPR/First Aid certifications with an expiration date of August 2020.

LPA discussed Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years. AB 633 was discussed with Licensee. Licensing forms, Title 22 regulations, can be obtained through the internet at ww.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com.

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. LPAs provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 07/16/19):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Marilou MonicoTELEPHONE: (408) 334-8549
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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: CHUANG, STEPHANIE
FACILITY NUMBER: 434412621
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2019
Section Cited
HSC
1596.8662(b)(1)
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MANDATED REPORTER TRAINING - On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training and shall complete renewal every two years following the date on which he or she completed the initial mandated reporter training.
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Stephanie states that proof of completion to be sent to Licensing by 08/16/19.
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This requirement is not met as evidenced by: LPAs observed that Licensee has not completed the Mandated Reporter Training. This poses a potential risk to health and safety to children in care.
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Type B
07/23/2019
Section Cited
CCR
102417(g)(9)(A)(1)
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OPERATION OF A FAMILY CHILD CARE HOME - Each family child care home shall conduct fire drills and disaster drills at least once every six months and document the drills.
This requirement is not met as evidenced by: LPAs observed that last fire drill was conducted on December 19, 2018. This poses a potential risk to health and safety to children in care.
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Licensee states she will practice fire drill with the children and will submit documentation to Licensing by 07/23/19.
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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: 07/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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: CHUANG, STEPHANIE
FACILITY NUMBER: 434412621
VISIT DATE: 07/16/2019
NARRATIVE
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(CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 07/16/19):

A review of staff records during today's inspection indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemption.

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

NOTICE OF SITE VISIT WAS ISSUED 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: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3