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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700011
Report Date: 09/30/2022
Date Signed: 09/30/2022 02:22:13 PM

Document Has Been Signed on 09/30/2022 02:22 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DENG, YUNERFACILITY NUMBER:
015700011
ADMINISTRATOR:DENG, YUNERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 415-2063
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
09/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Yuner DengTIME COMPLETED:
02:30 PM
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On September 30th, 2022 at 10:50am, Licensing Program Analyst (LPA) April Wright met with Licensee Yuner Deng for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present were eleven 11 preschool age children and fingerprint cleared assistant Anne Lorraine Dela Cruz. Hours of operation are Monday through Friday 8:00am - 5:30pm..

LPA toured the faculty to conduct a health and safety inspection. The 2 story home was clean and orderly, with heating and ventilation for safety and comfort of children in care. The isolation area is the chair in daycare room which is a section away from other children in care.

On limit areas include: Home office (child care room), converted downstairs bedroom (child care room), main house bathroom between the two day care rooms and the backyard. The ISOLATION AREA will be the downstairs converted bedroom into the day care area, away from other children in care.
Off-limits areas include: Living Room, Entire second level of home, kitchen, and garage.

The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision. There is a gate at the datc are room doorto prevent access to the upper level of the home and living room area. There are no pools hot tubs or any other bodies of water present in the on limit areas during todays inspection. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are ample age appropriate toys that appear to be safe and in good condition.

The home has two (2) fully charged fire extinguishers (2A10 BC and 3A40 BC), two (2) working smoke/carbon monoxide detectors and telephone. Per licensee there is a firearm in the home. LPA observed firearm in locked box with ammunition stored separately. The licensee is in compliance with the immunization laws which pertains to all childcare providers.

See LIC809 -C for continuance
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DENG, YUNER
FACILITY NUMBER: 015700011
VISIT DATE: 09/30/2022
NARRATIVE
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LPA requested and reviewed the files of eleven (11) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee has not conducted fire and disaster drills this year. Licensee has current CPR/First aid certificate which expires on 2/2023 and Mandated Reporter which was completed on 9.18/2021. The licensee is in ratio today. All required forms are posted and visible for public review.

Incidental Medical Services (IMS) policy was discussed. No IMS Provided at facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

California Law requires Child Care Centers licensees 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. 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 childcare facility must be reported to Community Care Licensing. The licensee was provided information regarding effects of Lead Exposure and testing requirements(Assembly Bill 2370)

See LIC 809C for continuance...
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DENG, YUNER
FACILITY NUMBER: 015700011
VISIT DATE: 09/30/2022
NARRATIVE
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Licensee was reminded that all adults 18 and over, 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 child care center. 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.


No deficiencies are cited during today's inspection.

Please see list below and attached advisory notes pages for additional information about technical violations issued today:

  • Technical Violation: C1 - C11 had incomplete files. Health History and Physicians Reports were not present in children's file.
  • Technical Violation: Licensee not conducting fire / emergency drills as required by licensing.


A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was reviewed with Licensee Yuner Deng
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6