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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423317
Report Date: 07/19/2022
Date Signed: 07/19/2022 01:53:10 PM

Document Has Been Signed on 07/19/2022 01:53 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:KUANG, HUITINGFACILITY NUMBER:
013423317
ADMINISTRATOR:KUANG, HUITINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 431-8279
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 8DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Huiting Kuang TIME COMPLETED:
02:10 PM
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On 07/19/2022 approximately at 11:00AM Licensing Program Analyst (LPA) Kelly Phan arrived at for an unannounced required inspection, and met with Licensee Huiting Kuang. Present for this inspection were the licensee, the licensee's fingerprinted and associated husband, her fingerprinted and associated mother, six preschool aged children along with her two school aged children (14 and 6) who resides at the home. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:30am to 6:00pm.

ON LIMITS: right-side bedroom #1 (isolation area), bathroom #1, fenced backyard, living room, dining room, and kitchen
OFF LIMITS: left side yard, green shed, back unit, flower garden, bedroom #2, bedroom #3, and bedroom #4. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. A child safety gate is being used as the Licensee is using a gate to keep children in the living room area. At 11:00AM, LPA observed there were ample age appropriate toys that were observed to be safe and in good condition. In the bottom drawer in the bathroom area, LPA observed several locks that were not locked properly; one drawer containing bleach and bottle of hand soap. LPA pointed out to licensee and immediately fixed the locks and checked each drawer for potential hazardous items. Technical violation will be issued. LPA also toured the right side bedroom, which is used for sleeping; LPA observed several toys and blankets inside sleeping play pens; Licensee states that she does not care for any infants at the moment but would allow children older than 2 years old to sleep with light bedding to prevent overheating; LPA advised licensee that since children are over 2 years old, they are allowed to use blankets, pillows, etc in the play pens. There was a fully charged 3A40BC fire extinguisher, working carbon monoxide, smoke detectors, and telephone. The home does not have a fireplace as the home has central heating. Per licensee, there are no firearms or any bodies of water in the home. Licensee has 4 rabbits in the OFF limit area (left side yard).

SEE LIC 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KUANG, HUITING
FACILITY NUMBER: 013423317
VISIT DATE: 07/19/2022
NARRATIVE
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The licensee conducts and documents fire drill log indicates a drill was conducted 03/21/22. All required licensing documents are posted and visible for public review. At 12:15pm, 5 children's files were reviewed and found to be incomplete. All five children files were missing required LIC forms including LIC 627 (Consent to Emergency Medical Treatment), LIC 613A (Personal Rights for Children), and missing two immunizations for two children files along with an incomplete file for 1 day care child. Type B violation was issued, see LIC 809D. Licensee has liability insurance from DCI (Day Care Insurance Services) valid until 10/07/2022. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. Licensee has proof of the required immunization. The licensee have required mandated reporter training that is completed as of 02/15/2021. Both licensee and licensee's husband has CPR and First Aid training are also valid for two years on 07/17/2021 from American Red Cross.

There were two deficiencies were cited for today's inspection: SEE LIC 809D
Type B - Licensee failed to have required licensing documents for 5 children files
Type B - Licensee failed to maintain immunizations for all five children; two children files has immunizations however it was not documented on California blue immunization card.

Appeal rights and a notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. Exit interview conducted and report was reviewed with licensee Huiting Kuang

Incidental Medical Services (IMS) policy was discussed. This facility does not provides IMS to children in care. 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.htm.”

SEE LIC 809 C



SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KUANG, HUITING
FACILITY NUMBER: 013423317
VISIT DATE: 07/19/2022
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LPA discussed the safe sleep regulations with licensee 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 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.

Licensee 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.

Licensee was reminded that California Law requires licensed Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. Licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/19/2022 01:53 PM - It Cannot Be Edited


Created By: Kelly Phan On 07/19/2022 at 01:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KUANG, HUITING
FACILITY NUMBER: 013423317

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above as all 5 children files did not have immunizations, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/26/2022
Plan of Correction
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Licensee would maintain and document immunizations on California blue immunization form by 07/26/2022
Licensee would send proof to LPA by 07/26/2022
Type B
Section Cited
CCR
102421(a)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above as all 5 children files did not have required licensing forms completed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/26/2022
Plan of Correction
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Licensee would provide licensing forms to children parents to complete by 07/26/2022
Licensee would send proof to LPA by 07/26/2022
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Kelly Phan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2022


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