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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416219
Report Date: 10/16/2019
Date Signed: 10/16/2019 11:15:20 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:ZHANG, LUFACILITY NUMBER:
434416219
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
10/16/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Lu ZhangTIME COMPLETED:
11:25 AM
NARRATIVE
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Licensing Program Analyst (LPA) Oscar Huang conducted an announced prelicensing inspection to the home today. LPA met with Lu Zhang, Applicant, and explained the nature of today's inspection to her. The adults that reside in the home are the applicant and her husband. Days and hours of operation will be Monday - Friday from 8:30 AM to 6:30 PM. Applicant has completed her Preventative Health and Safety Child Care Training which includes an hour of nutrition on 11/18/2017, and a copy of the certification card is on file. Applicant's CPR and First Aid certifications are current and expire on 12/2019, Applicant rents the home. A lease agreement is obtained on site. The property landlord consent and notification to use for FCCH is also obtained on site. Applicant stated that she will purchase child care liability insurance. LPA reminder Applicant that before she has purchased liability insurance and she will need to obtain the singed affidavit regarding liability insurance for Family Child Care Home to the parents of children in care.

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, dinning room, family room, and bathroom #1. LPA observed two screened fireplaces. Off limit areas inside the home: kitchen, all four bedrooms, bathroom #2, heater closet, and garage. Off Limit areas outdoor: back portion of backyard, and two side yards. LPA observed a fully charged 3A40BC fire extinguisher, one functioning carbon dioxide detectors, at least two 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. Applicant states that there are no weapons or pets in the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. LPA reminded Applicant that smoking, drop side cribs, and baby walkers, bouncers, excer-saucers, jumpers etc. are not allowed in Family Child Care Homes. Licensee was advised to keep temperature within 68-85 degrees.



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 except one tenant who needs to be transferred to applicant's facility. LPA reminded Applicant 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.
Facility Evaluation Report dated 10/16/19 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: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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 2
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: ZHANG, LU
FACILITY NUMBER: 434416219
VISIT DATE: 10/16/2019
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Facility Evaluation Report dated 10/16/19 to be continued from previous page:
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/training/childcare.htm. Applicant has completed her training on 07/17/2019 and the certification of completion is on file.

Forms of discipline used by Applicant: talking to children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

LPA reviewed safe sleep policies for the infants with the Applicant and provided "A Child Care Provider's Guide to Safe Sleep. More information can be founded at http://www.cdss.ca.gov/inforesources/Child-Care-Licensing. A Family Child Care Home packet with updated Licensing forms was provided to and reviewed with the Applicant. Department website: www. ccld.ca.gov provided to Applicant. LPA also discussed with applicant regarding infant equipment accessory recalls.

LPA discussed the requirements of AB 633 with the Applicant and provided her the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and Applicant understands the requirements. LPA also discussed AB 2231: Civil Penalty Updates effective July 1, 2017 with applicant. 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. LPA discussed SB 792 Immunization Requirement with applicant. LPA observed appropriate records for immunization against measles, pertussis, and influenza for applicant in file. Incidental Medical Services (IMS) were discussed with Applicant. Applicant stated that she is not providing IMS at this time. Applicant will submit a plan of operation for IMS if in the future they provide any IMS to a child in care.

LPA conducted an exit interview with the Applicant and advised her that a small Family Child Care Home license is now pending upon submitting the following items to CCL and the management approval:

1. An update Emergency Disaster Plan for Family Child Care Homes


2. A photo image of repaired falling fence panel.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng HuangTELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2