015700260-2-19-2025-52-CC-MPRE-DE2TKY-20250219134844

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700260
Report Date: 02/19/2025
Date Signed: 02/19/2025 01:49:02 PM

Document Has Been Signed on 02/19/2025 01:49 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/ DIRECTOR:	WANG, DING		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(720) 201-5334
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94542
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 10	DATE:	02/19/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:35 AM
MET WITH:	Ding Wang		TIME VISIT/ INSPECTION COMPLETED:	01:46 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 2/19/2025 at 9:35am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Ding “Kelly” Wang for an unannounced annual/random inspection. Present during the inspection was the Licensee, her two (2) adult helpers, three (3) infants, and seven (7) preschool age children. Licensee lives in the home with her husband and their three (3) minor children. Licensee’s home was toured for a health and safety inspection. The facility operates 8:30am – 5:30pm, Monday – Friday. ON LIMITS AREA: Kitchen, den/office, 2^nd floor bathroom, 2^nd floor living room, 2^nd floor bedroom (next to front door used for napping and activities), 1^st floor living room and attached balcony (currently not in use), backyard and front yard OFF LIMITS AREA: Dining room, 1^st floor bedroom and bathroom, 1^st floor storage area, entire 3^rd floor, laundry room on 2^nd floor, and garage ISOLATION AREA: Den/office The facility is a three story home owned by the Licensee. The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children’s learning and play. Licensee provides all meals and snacks for the children and all food that is brought from the children’s home will be properly labeled and stored. Licensee uses high chairs and feeding chairs for meal times. All materials used for eating was observed to be well maintained, free from defect and in proper working order. Licensee provides sleeping mats and bedding for napping. All off-limit areas in the home were made inaccessible with locks and gates. Licensee stated she does not transport children, there are no firearms and there is one (1) small dog in the home. Page 1 of 5

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

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 9

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: 02/19/2025

NARRATIVE

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At 9:44am LPA observed cleaning products, such as Lysol, Raid and Comet, in the second-floor bathroom shower and next to the toilet (see LIC809-D). During LPA’s previous inspection on 10/4/2023 the same cleaning products were found in the same shower and LPA had instructed Licensee to remove them to an inaccessible area. Licensee stated she thought LPA had instructed her to “just close the shower door,” since it is “really heavy.” LPA reminded Licensee of the instructions given during the previous inspection and reminded Licensee that LPA gave a Technical Violation in the Facility Evaluation Report about the cleaning products during the 2023 inspection.

At 9:52am LPA observed two (2) infant rockers in the second-floor bedroom (see LIC809-D). During LPA’s previous inspection on 10/4/2023, LPA informed Licensee that rockers were not allowed in care, and they needed to be permanently removed from the children’s accessible areas. During the 2023 inspection Licensee stated that she would permanently remove the rockers and had placed them in an unused play yard to be removed. During today’s inspection, the same two (2) rockers were seen in the room on the floor for children to use. Licensee stated that the children “don’t sleep in them” and LPA reminded Licensee of the instructions given during the previous inspection and that LPA had given a Technical Violation in the Facility Evaluation Report about the two rockers during the 2023 inspection.

LPA observed 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 2^nd and 3^rd 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 3^rd floor is gated and the stairs leading to the 1^st floor has a door that is closed off to the children. The home is equipped with central heat and air for proper ventilation. LPA did not observe any harmful bodies of water in or around the home. There are no pools or jacuzzis at the home.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 2 of 9

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: 02/19/2025

NARRATIVE

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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 1st floor balcony. Licensee stated the children do not use the walkway to the balcony 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 a hill, Licensee stated there is always an adult present for full supervision when children are outside.

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 training is complete and expires 8/4/2025. Licensee’s Mandated Reporter training has been completed and expires 5/9/2025. Fire/disaster drills have been conducted and documented, with the last drill logged on 10/14/2024. LPA verified all adults living and working in the home have obtained a criminal record clearance. All required forms are currently posted on the wall by the front door of the home. LPA obtained a sample of the children’s files, and facility files. Through record review it was found that one of Licensee's helpers is missing an MMr immunization record. Licensee was informed of the missing immunization record during LPAs previous inspection in 2023. Four of the six children's files reviewed were missing immunization records as well (See LIC809-D).

Deficiencies cited during LPA’s inspection

Cleaning products in areas that are accessible to children in care
Rockers in areas that are accessible to children in care
Four of six files reviewed were missing immunization record
Licensee's helper missing immunization record for MMr (measles, mumps & rubella)

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's authorized representatives, and to Community Care Licensing Division (CCLD) within 24 hours by phone. Within seven (7) days of the incident, Licensees must submit the Unusual Incident/Injury form (LIC 624B) to CCLD. Licensee was reminded that any structural changes or additions to the home must be reported to CCLD. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 3 of 9

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: 02/19/2025

NARRATIVE

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EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting 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.

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.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 4 of 9

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: 02/19/2025

NARRATIVE

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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.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 5 of 9

Document Has Been Signed on 02/19/2025 01:49 PM - It Cannot Be Edited

Created By: Morgan Pringle On 02/19/2025 at 12:44 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: WANG, DING	FACILITY NUMBER: 015700260
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(d)(1)

Operation of A Family Child Care Home

(d) The home shall provide safe toys, play equipment and materials. (1) Fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission shall not be used for children in care or accessible to children in care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA observed 2 infant rockers in the 2nd floor bedroom. Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/21/2025
	Plan of Correction
1 2 3 4	Licensee will permanently remove the 2 rockers from the on limit areas of the home and, moving forward, will not use them, or have them available, during hours of operation for the children in care. Licensee will send send LPA Pringle pictures of rockers in off limit areas and inform LPA when they are removed by POC date. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

Type B

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA observed cleaning products in the on limit 2nd floor bathroom. Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/21/2025
	Plan of Correction
1 2 3 4	Licensee will permanently remove the cleaning products and place them in an off limit area by POC date. Licensee will send LPA pictures of bathroom showing removed items by POC date as proof of completion. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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:

Morgan Pringle

LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

Page: 6 of 9

Document Has Been Signed on 02/19/2025 01:49 PM - It Cannot Be Edited

Created By: Morgan Pringle On 02/19/2025 at 12:44 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: WANG, DING	FACILITY NUMBER: 015700260
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Licensee's helper is missing a record for MMr. Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/21/2025
	Plan of Correction
1 2 3 4	Licensee will ensure that helper obtains a immunization record for the missing vaccine. Licensee will obtain records from helper POC date and submit copies to LPA Pringle. If record cannot be obtained, an appointment will need to be scheduled with personal physician and document submitted showing appt. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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
1 2 3 4	Four of the six children's files reviewed were missing an immunization record. Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/24/2025
	Plan of Correction
1 2 3 4	Licensee will obtain missing immunization records by Monday, 2/24/2025 and will submit a copy to LPA Pringle by end of day as proof of correction. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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:

Morgan Pringle

LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025

LIC809 (FAS) - (06/04)

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