434416336-10-5-2021-07-CC-YHUG-C7HPQT-20211005113141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416336
Report Date: 10/05/2021
Date Signed: 10/05/2021 11:32:22 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:	CHANG, CHIH & YI, BINGXIN		FACILITY NUMBER:	434416336
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	10/05/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Chih Chang & Bingxin Yi		TIME COMPLETED:	11:50 AM

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Licensing Program Analyst (LPA) Oscar Huang conducted an announced relocation case management inspection and met with Chih Chang & Bingxin Yi (Husband & Wife), Applicants for a small Family Child Care Home license. LPA noted that Applicant Bingxin Yi is current a small family child care home licensee at 6831 Piedmont St. Chino, licensee# 364845521 with Riverside Regional Office, and facility file has been transferred.

The adults that reside in the home is both applicants. Days and hours of operation will be Monday - Friday from 8AM to 6PM. Applicants had completed their Preventative Health and Safety Child Care Training which includes an hour of nutrition & lead poisoning prevention on 09/23/2021 & 06/07/2020, and copy of the certifications are on file. Applicants' CPR and First Aid certifications are current and expire on 05/15/2023. Applicant rent the home and a copy of lease agreement & landlord/owner consent are on file. LPA reminder Applicants if they did not purchase liability insurance, they will need to issue affidavit regarding liability insurance for their Family Child Care Home to the parent of child 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, family room, bedroom #1, and bathroom # 1. LPA observed one screened fireplace. Off limit areas inside the home: two other bedrooms (#2 & #3), bathroom #2, kitchen, and garage. Off Limit areas outdoor: locked storage shed & gated right side. LPA observed a fully charged 3A40BC fire extinguisher, one functioning carbon dioxide detector, at least one working smoke detector, 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, a vaccinated spaniel dog in the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. LPA reminded Applicants that smoking, drop side cribs, and baby walkers, bouncers, excer-saucers, jumpers etc. are not allowed in Family Child Care Homes. Applicants were advised to keep temperature within 68-85 degrees.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

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: CHANG, CHIH & YI, BINGXIN	FACILITY NUMBER: 434416336
	VISIT DATE: 10/05/2021

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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 reminded Applicants 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 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. Applicants had completed their on training 5/31/2021 & 9/23/2021.

Forms of discipline were discussed with Applicants. Applicants understand 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 Applicants 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 Applicants and provided "A Child Care Provider's Guide to Safe Sleep & Individual Infant Sleeping Plan (LIC 9227) and included the recent released PIN 20-24-CCP including Providers must check on sleeping infants every 15 minutes and document their condition to check for signs of distress, which includes, but is not limited to labored breathing, flushed skin color, increase in body temperature, and restlessness . More information can be founded at http://www.cdss.ca.gov/inforesources/Child-Care-Licensing.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

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: CHANG, CHIH & YI, BINGXIN	FACILITY NUMBER: 434416336
	VISIT DATE: 10/05/2021

NARRATIVE

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LPA discussed the requirements of AB 633 with the Applicants and provided them the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and Applicants understand 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 Applicants. LPA observed appropriate records and physician notes for immunization against measles, pertussis, and influenza for applicants in file. Incidental Medical Services (IMS) were discussed with Applicants. Applicants are not providing IMS at this time. Applicants will submit a plan of operation for IMS if in the future they provide any IMS to a child in care.

LPA reviewed COVID-19 infection prevention guidance & self-assessment with Applicants including the plans in place to protect and to support staff &children, as well as essential protective equipment and supplies, cleaning & hygiene implementation, arrival procedures, health screening & social distancing practices and meal times.

LPA advised Applicants that 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.

LPA conducted an exit interview and advised the Applicants that their small Family Child Care Home license is now pending on receiving the following items in the office & management approval:

1. Chih Chang's Family Child Care Home Orientation Certificate.

2. Both Chih Chang & Bingxin Yi 's TB Clearance/risk assessment proofs within 12 months.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Yangcheng Huang	TELEPHONE: 408-334-8321
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

LIC809 (FAS) - (06/04)

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