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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013424020
Report Date: 01/06/2025
Date Signed: 01/06/2025 12:57:58 PM

Document Has Been Signed on 01/06/2025 12:57 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LAC. LINHFACILITY NUMBER:
013424020
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/06/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:34 AM
MET WITH:Linh LacTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On January 6, 2025, at 8:40AM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an
announced change of location pre licensing inspection and met with Licensee Linh Lac. LPA disclosed the
purpose of the inspection and was granted entry into the home. Residing in the home is the Licensee, her
fingerprint cleared husband and two underage children. No children in care were present during the today's
inspection. The home was toured to conduct a health and safety inspection and the hours of operation are
between the 8:00AM to 6:00PM, Monday -Friday.

This home is a two story single family house with four bedrooms and two and half bathrooms, which was
observed to be neat and clean with heating and ventilation. The entrance to the child home is the front door.
There are age appropriate toys that appeared to be safe, clean and in good repair. LPA did not observe any
hazardous materials, medication or toxins accessible to children during today’s inspection. There is a fireplace
in the main area of the day care that is blocked off and covered to prevent by children access. The stairs
leading to the second floor has been gated off. LPA did not observe bodies of water or pools accessible to
children in care during today’s inspection. Licensee confirmed there are firearms locked and stored in an off
limit area of the home. During today's inspection LPA observed the firearms and ammunition locked and
stored separately. Licensee has stated she will be using the right side of the first floor for her day care and the
left side will be off limit to children in care.
On-limit-areas are the: living room which has been converted to the main area of the day care, the
downstairs half bathroom, the room next to the sliding door that leads to the backyard, the main area of the
backyard, and the right side of the backyard leading to the front of the house.
Off-limit-areas are the: entire upstairs (which includes the four bedrooms, two full bathrooms, and the
balcony), the entire left side of the first floor that includes the kitchen, the dining area and the family room, the
gated left side of the backyard, and the garage, which will be made inaccessible by closed and/or locked
doors and visual supervision.
Report Continues on 809-C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2025
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 3
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: LAC. LINH
FACILITY NUMBER: 013424020
VISIT DATE: 01/06/2025
NARRATIVE
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The Isolation area for a sick child will be the table area next to the entrance of the child care home away from
other children in care.

The home has a fully charged 2A10BC fire extinguisher in kitchen, a working smoke detector in the main
room of the day care, a carbon monoxide detector in hallway located in the middle of the house and Licensee
has a working telephone number. Licensee has completed her Health and Safety training and has a current
first aid CPR certificate that expires on 5/2025. Licensee has completed the required mandated reporter
training which was completed on 5/2025. The Licensee is in compliance with the immunization laws which
pertains to all childcare providers. All required forms are posted and visible for public review from the
childcare room. Licensee has provided proof of control of property.

The licensee has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this
consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6
children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new
Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee
of $25, to increase the capacity and provide care to 8 children.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual -
Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.htm

LPA informed the applicant that all forms can be downloaded at www.ccld.ca.gov and encouraged the
licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates
distribution list. The licensee was also reminded that Mandated Reporter Training is required for all staff and
is to be renewed every 2 years by visiting www.mandatedreporterca.com.
See 809-C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: LAC. LINH
FACILITY NUMBER: 013424020
VISIT DATE: 01/06/2025
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CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the
day-care facility. Roster of the children must be properly maintained and fire/disaster drill every six months
must be documented. The licensee is reminded any structural changes to the home or additions to the child
care facility must be reported to Community Care Licensing.

The 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.

On this date 1/6/2025, the California Attorney General - Megan’s Law website was searched for information
on sex offenders required to register with local law enforcement under California's Megan's Law. No
registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders
are not subject to public disclosure; therefore, they may not have been included in this search. However, the
Department conducts a monthly cross reference of each address on record for all registered sex offenders
against all CCLD facility addresses pursuant to information shared by California DOJ.
Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families
obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs)
throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and
stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other
important information communication platforms. To receive important licensed related information to licensed
facilities, visit the CCLD Important Information website at
https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to
receive email communication.

As of today's date 1/6/2025 the home is now licensed and can provide care to children.
Exit interview conducted and report was reviewed with the licensee.
Report, and Appeal Rights provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025
LIC809 (FAS) - (06/04)
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