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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416188
Report Date: 08/08/2019
Date Signed: 08/08/2019 10:03:02 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:HUANG, YANFACILITY NUMBER:
434416188
ADMINISTRATOR:YAN HUANGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 202-7591
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY:14CENSUS: 0DATE:
08/08/2019
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Yan HuangTIME COMPLETED:
10:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Oscar Huang met with Licensee, Yan Huang for an announced inspection in response to licensee relocation request. Licensee currently has a large FCCH license (#434414228) located at 879 Acacia Avenue, Sunnyvale, CA 94086. LPA explained the nature of today’s inspection to Licensee. LPA observed no children at home. Days and hours of operation are Monday to Friday, 8:30am to 6:30pm. The adults that reside in the home are Licensee and her adult son.
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 appears clean and orderly, with heating and ventilation for safety and comfort of the children. Licensee was advised to keep temperature within 68-85 degrees. LPA observed no baby walker, bouncers, excer-saucers, jumpers etc. on the premises. LPA observed no stairs inside the home. The main area of the home is used for the day care are living room, kitchen, bedroom #2 and bathroom #1. LPA observed a blocked 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 in top cabinets in the kitchen inaccessible to children. LPA observed a fully charged 3A40BC fire extinguisher, at least 3 working smoke detectors and a functioning carbon monoxide detector. Licensee states there are no weapons/firearms in the home. Off limit areas indoor: bedroom #1, master bedroom, master bathroom, storage, and garage. LPA observed a fenced backyard and no bodies of water. Off limit areas outside the home: Right portion of backyard where a storage shed is located and both side yard.
Facility Evaluation Report dated 08/08/2019 to be continued on next page:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
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: HUANG, YAN
FACILITY NUMBER: 434416188
VISIT DATE: 08/08/2019
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Facility Evaluation Report dated 08/08/2019 to be continued from previous page:
Licensee rents the house, and a copy of Property Owner/Landlord Notification is on file. Licensee stated she will carry the child care liability insurance once the license is approved. LPA advised licensee that before the insurance is obtained, she will need to obtain signed Affidavit Regarding Liability Insurance For Family Child Care Home from parents of children in care and keep it on each child's file. LPA observed Licensee has current CPR and First Aid certification expiring 09/2020.
Supervision of children was discussed with Licensee, and she understands that they must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options. Licensee states that they do not transport children via vehicle but they understand 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 provided Infant equipment recall PINs to licensee and advised her that those can not be used.
LPA discussed AB 2231: Civil Penalty Updates effective July 1, 2017 with Licensees. 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 immunization against measles, pertussis, and influenza statements for Licensee and her assistants.
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. Licensee requested that she and her helpers to be exempted from training until a Chinese version is available due to their limited English.

A fire safety inspection approval was received from the Sunnyvale Fire Department on 07/24/19. No children allowed in garage.

No Deficiency was cited. Exit interview conducted with Licensee, and advised her that her large license at this new location is now pending upon submit the following to CCL and management approval:

1. Proof of complete of 8 hours Preventative Health and Safety Child Care Training which includes an hour of nutrition class.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
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