434416072-10-10-2019-07-CC-YHUG-BGTN4X-20191010100841

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416072
Report Date: 10/10/2019
Date Signed: 10/10/2019 10:08:46 AM

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:	LIANG, YAN YING		FACILITY NUMBER:	434416072
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	10/10/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Yan Ying Liang		TIME COMPLETED:	10:20 AM

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 Licensee Lina Guo for an unannounced Case Management inspection in response to licensee's increase capacity request. LPA explained the nature of today’s inspection to Licensee. Present were five day care children( two infants & three preschool children) and a finger print clearance assistant. Days and hours of operation are Monday to Sunday, 8:30 a.m. to 6:30 p.m. The adults that reside in the home are Licensee and a tenant only. 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. LPA toured the indoor and outdoor areas during today's inspection. The entire home was inspected for health and safety hazards. LPA observed no stairs inside the home. The main area of the home is used for the day care are living room, family room, dinning room, bedroom #1 and bathroom #1. LPA observed a blocked fireplace. Off limit areas inside the home: kitchen, bedroom #2 & #3, bathroom #2, and garage. LPA observed a fully charged 3A40BC fire extinguisher, one functioning carbon dioxide detectors, one working smoke detectors, fenced backyard, and no bodies of water. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Licensee stated that there are no weapons or pets in the home. LPA observed no baby walker, bouncers, excer-saucers, jumpers etc. on the premises. Licensee rent the house, and has child care liability insurance under United States Liability Insurance Company. Facility Evaluation Report dated 10/10/2019 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: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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: LIANG, YAN YING	FACILITY NUMBER: 434416072
	VISIT DATE: 10/10/2019

NARRATIVE

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Facility Evaluation Report dated 10/10/2019 to be continued from previous page:
LPA observed Licensee has current CPR and First Aid certification expiring 07/2020. LPA observe a current roster of the children. The last fire and disaster drills log was conducted on 10/01/2019. LPA reviewed all 5 children files. Immunization records are maintained and up-to-date.

Supervision of children was discussed with Licensee, and she understands that she 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. LPA provided Licensee with both small and large ratio/capacity chart for her reference. Licensee states that she does not transport children via vehicle but 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 also discussed with licensee regarding Infant equipment recalls.

LPA discussed SB 792 Immunization Requirement with Licensee. LPA observed appropriate records for immunizations against for licensee and her assistant. 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: https://mandatedreporterca.com/. Licensee has completed her training on 04/08/2018, and the certification is on file. Her helper requested to be exempted from the training due to limited English.

A fire clearance approval from Sunnyvale Fire Department was received on 10/07/2019 - No children allowed in garage for day care.

No Deficiency was cited. Exit interview conducted with Licensee and advised her that a large Family Child Care Home license is now pending upon the management approval.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST REMAIN POSTED WITH TYPE A DEFICIENCIES NEAR THE ENTRANCE 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: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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