015700260-10-4-2023-52-CC-MPRE-CWAS4X-20231004133327

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700260
Report Date: 10/04/2023
Date Signed: 10/04/2023 01:33:42 PM

Document Has Been Signed on 10/04/2023 01:33 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:	WANG, DING		FACILITY NUMBER:	015700260
ADMINISTRATOR:	WANG, DING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(720) 201-5334
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94542
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 9	CENSUS: 9	DATE:	10/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:26 AM
MET WITH:	Ding Wang		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/4/2023 at 10:26am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Ding (Kelly) Wang for a Required – 1 Year Inspection. Present during the inspection was the Licensee, her helpers Li Xiang Wang and Zhen Zhen Zhu, four (4) infants and five (5) preschool age children. Licensee’s two four (4) year old daughters, one (1) year old son and mother, Jin Zhang were present upstairs in an off-limit area as well. Licensee lives in the home with her husband, Yake Feng, their three (3) children and her mother. The facility operates 8:30am – 5:30pm, Monday - Friday. ON LIMITS AREA: Kitchen, Den/Office (currently not in use), 2^nd Floor Living Room, 2^nd Floor Bedroom, 1^st Floor Living Room and Attached Balcony (currently not in use), Backyard and Front Yard OFF LIMITS AREA: Dining Room, 1st Floor Bedroom and Bathroom, Storage Area, Entire 3^rd Floor, Laundry Room, and Garage ISOLATION AREA: Den The facility is three story home owned by the Licensee. The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, personal medications, and hazardous materials were observed to be in inaccessible areas. Licensee stated that she provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. Highchairs and booster chairs are used for eating. All materials used for eating was observed to be well maintained, free from defect and in proper working order. Licensee uses cots and play yards for sleeping. All napping equipment was observed to be clean and free from defects. All off limit areas are made inaccessible with gates, locks, and closed doors. Licensee stated she does not transport children. There is one (1) dog and no firearms in the home. Page 1 of 4

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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: WANG, DING	FACILITY NUMBER: 015700260
	VISIT DATE: 10/04/2023

NARRATIVE

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There is one (1) fully charged 3A40BC fire extinguisher in the laundry room under the sink. There is one (1) working smoke detector above the staircase that connects the second and third floors, in the 2^nd floor bedroom, and in the 1^st floor living room. There is one (1) carbon monoxide detector in the kitchen. There is a pull-down fire alarm installed by the front door and exit signs are posted throughout the home. The fireplace in the living room has been blocked and locked and the electric fireplace in the den is blocked with furniture making it inaccessible to children. The stairs leading to the third floor is gated and the stairs leading to the first floor has a door that is closed off to the children. The home is equipped with central heat and air for proper ventilation.

The front yard is fully fenced with ample age-appropriate materials for the children. The back yard is fenced with a latched gate that leads to the 1^st floor balcony. Licensee stated the children do not use the walkway as the home is on a sloped hill and the walkway is not fenced. There are swings, a play structure, and a small trampoline in the back yard of the facility. All structures are secured into the ground and made safe for children in care. Due to the home being on hill Licensee stated there is always and adult present for full supervision when children are outside. LPA did not observe any bodies of water in or around the home.

The facility is operating within its licensed capacity and is in ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid has been complete and expires 8/4/2025. Licensee’s Mandated Reporter training is complete and expires 5/9/2025. Fire/disaster drills have been conducted with the last drill logged 8/14/2023. All required forms are posted and visible for public view by the front door. All adults living and working in the home have obtained a criminal record clearance. LPA obtained a sample of the children’s files, the helper’s file, and the facility files. All files were complete.

No deficiencies were cited during this inspection.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC809 (FAS) - (06/04)

Page: 6 of 8

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: WANG, DING	FACILITY NUMBER: 015700260
	VISIT DATE: 10/04/2023

NARRATIVE

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Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC809 (FAS) - (06/04)

Page: 7 of 8

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: WANG, DING	FACILITY NUMBER: 015700260
	VISIT DATE: 10/04/2023

NARRATIVE

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During the exit interview, Licensee Ding Wang, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

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-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Ding (Kelly) Wang.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC809 (FAS) - (06/04)

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