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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416336
Report Date: 12/28/2021
Date Signed: 12/28/2021 02:24:11 PM

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, BINGXINFACILITY NUMBER:
434416336
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
12/28/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Chih Chang & Bingxin YiTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Oscar Huang met with Licensees, Chih Chang & Bingxin Yi for an unannounced case management inspection due to licensees' Capacity Increase Request & Post-Licensing visit. LPA explained the nature of today’s inspection to Licensees. LPA observed 5 daycare children (2 infants & 3 preschoolers) in the home during today's inspection. Days and hours of operation are Monday to Friday, 8:00 a.m. to 6:00 p.m. The adults that reside in the home are licensees (husband & wife).

Licensees, Chih Chang & Bingxin Yi was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. 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 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 licensees that smoking, drop side cribs, and baby walkers, bouncers, excer-saucers, jumpers etc. are not allowed in Family Child Care Homes. LPA observed 71 degree on thermostat, and advised licensees to keep temperature within 68-85 degrees.

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

DATE: 12/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021
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: CHANG, CHIH & YI, BINGXIN
FACILITY NUMBER: 434416336
VISIT DATE: 12/28/2021
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Licensees rent the house. do not carry child care liability insurance, LPA observed Affidavit Regarding Liability Insurance was signed by parents and kept on file. LPA observed Licensees have current CPR and First Aid certifications expiring 5/2023. Licensees have completed their mandated reporter trainings on 09/23/2021 & 06/07/2020 for child care providers and the certifications are on file. LPA observed a current roster of the children. LPA reviewed all children files mandated by the regulation.

LPA discussed the safe sleep regulations with licensees, Chih Chang & Bingxin Yi and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA observed Infant Sleeping Plan for children under 1 year old and 15 minutes check logs for under 2 years old.

Incidental Medical Services (IMS) policy was discussed. 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: https://www.ada.gov/childqanda.htm



A fire clearance granted from the San Jose Fire Department was received on 12/20/2021 and was on file: Approved for Daycare use: Bedroom #3, Living Room, Kitchen, Family Room & Backyard. Areas not approved for Daycare use: Bedroom #1 /+#2, Bathroom #2, Garage, Backyard shed.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with licensees, Chin Chang & Bingxin Yi and advised them that a Large Family Child Care Home license is now pending upon management approval.

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

DATE: 12/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021
LIC809 (FAS) - (06/04)
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