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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700004
Report Date: 06/08/2022
Date Signed: 06/08/2022 09:20:45 AM

Document Has Been Signed on 06/08/2022 09:20 AM - 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:YANG, YANGFACILITY NUMBER:
015700004
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
06/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:32 AM
MET WITH:Yang Yang- LicenseeTIME COMPLETED:
09:30 AM
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On 6/8/22 at 8:32am, Licensing Program Analyst Briana Plumboy met with licensee Yang Yang for an ANNOUNCED CASE MANAGEMENT INSPECTION. Present for the inspection was licensee's infant daughter, preschool age daughter, licensees fingerprint clear and associated husband Jingbao Liu, and licensees fingerprint clear and associated mother Yulan Zhang. This facility was on inactive status effective 7/14/21 and would like to be placed back on active status.
The home is a dual level home. The home consists of a dining room, kitchen, living room, 2 bedrooms, 1 master bedroom with a bathroom, a upstairs hallway bathroom, a garage, a downstairs bedroom which can be accessed through a door from the top level of the home, and a storage room located off the garage. The stairs which lead downstairs has a gate located at the top and bottom during today's inspection. The kitchen has a gate located between the dining room and kitchen area during today's inspection and there is a door which can be utilized to close off the entrance way of the kitchen from the hallway. The OFF LIMIT AREAS are the kitchen, 2 bedrooms, master bedroom with master bathroom, and entire bottom level of the home which includes the garage, room, and storage room and will be inaccessible by gates, closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room, dining room, and upstairs hallway bathroom. The ISOLATION AREA will be the dining room. Outdoor play area will be located inside the backyard. The backyard has a deck, base level, and a upper level. The outdoor play area is fenced. During today's inspection, there are child safety gates located at the top and bottom of the outdoor steps which lead from the top deck to the lower level of the backyard. Per licensee, the children in care will utilize the deck and bottom level of the right side of the base of the backyard which is padded today with cushioned tiles and located off the right of the stairs. There is a sandbox located in the backyard and licensee is aware she must clean it regularly and ensure there are no toxins or debris inside. There is also a trampoline located in the backyard which is off limits to children in care. There are toys and learning
See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YANG, YANG
FACILITY NUMBER: 015700004
VISIT DATE: 06/08/2022
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materials. There are no pools, hot tubs or any other bodies of water on the premises during today's inspection. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee’s Health and Safety training is completed and CPR and First Aid certificate is current and expires 05/05/24. The licensee's mandated reporter training certificate is valid and expires 06/03/24. The licensee and her husband Jingbao Liu are in compliance with the immunization law which pertains to day care providers. The fireplace is covered by a wooden barricade which is padded with cushioning and rubber bumper pads on the corners to prevent access by children. Per licensee, there are no firearms in the home.

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Vanessa Crabtree 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 Vanessa Crabtree 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.

The facility is placed back on active status. No deficiencies cited during today's inspection. An exit interview was conducted. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Appeal rights provided and discussed.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
LIC809 (FAS) - (06/04)
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