<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700316
Report Date: 06/29/2022
Date Signed: 06/29/2022 01:27:21 PM

Document Has Been Signed on 06/29/2022 01:27 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:LIEN, SHUANGFACILITY NUMBER:
015700316
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
06/29/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Shuang LienTIME COMPLETED:
01:45 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 06/29/2022 Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced Plan of Correction (POC) inspection and met with Licensee Shuang (Connie) Lien and explained the purpose of the visit. Present for the inspection was licensees fingerprint cleared and associated mother and assistant and 5 daycare children.

On 05/11/2022 the facility was cited a Type A deficiency on CCR 102416.5(b)(1)(2) Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided. The POC due date was 5/12/2022 however, due to COVID positives in the facility the POC inspection was delayed. On 5/11/2022 the facility was also cited an additional Type A deficiency on HSC 1597.45 Small family day care homes. All of the following shall apply to small family day care homes, (a) The use of a single-family residence as a small family day care home shall be considered a residential use of property for the purposes of all local ordinances. LPA checked all bedrooms and reviewed sufficient evidence that licensee is living in the home. LPA also observed 1 infant and 4 preschool children sleeping during the inspection. LPA Miller will clear both deficiencies cited on 5/11/2022 as of todays date.

A notice of site visit was given and must be posted for 30 days and this report shall remain on file for 3 years. Exit interview conducted with licensee, Shuang (Connie) Lien.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2022
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 1