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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700336
Report Date: 09/06/2023
Date Signed: 09/06/2023 02:39:38 PM

Document Has Been Signed on 09/06/2023 02:39 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:GUAN, RUIYANGFACILITY NUMBER:
015700336
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 2DATE:
09/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Ruiyang GuanTIME COMPLETED:
02:50 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 September 6, 2023 at approximately 12:40pm Licensing Program Analyst (LPA) Russ Haderer arrived unannounced to meet with licensee Ruiyang Guan for the purpose of conducting a case management / capacity change inspection. Present in the home today was licensee Ruiyang Guan, two Chinese speaking consultants and two children in care (all two years old). The facility is in ratio today. Hours of operation are 8:00am to 6:00pm.

All requested documents were received for the increase of capacity application. The fire clearance for a capacity of 14 was approved by the Fremont Fire Department on 8/30/2023 (received by Licensing on 8/29/2023). The Licensee is reminded to abide by the conditions of the fire clearance (day care not permitted in the garage). Pull down fire alarm is located near the front door of the home. A self-closing solid door is located in the kitchen to enter the garage.



The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. A copy of the approved children ratios was printed and given to licensee. If licensee has the maximum of 14 children in care, a signed LIC9149 will be required from all parents of children in care.

Requirements for assistants:


Fingerprint clearance
LIC 501 Personnel Record Application (or job app)
LIC508 Criminal Record Clearance (if requested by The Guardian)
LIC 9052 Employee Rights (signed by employee)

List continued on next page...........
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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 4
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: GUAN, RUIYANG
FACILITY NUMBER: 015700336
VISIT DATE: 09/06/2023
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
26
27
28
29
30
31
32
Immunizations for: Measles; (MMR), pertusis (tdap), flu shot (influenza flu shot may be declined with a signed and dated note stating the election not to have a flu shot)
Clear TB test with a negative result or x-ray clearance
CPR/1st Aide if ever left alone with children
Mandated Reporter (current within 2-years, not expired)
LIC 9108 Statement Acknowledging requirement to report child abuse

The facility is a single story 3-bedroom, 2 bath home with an attached 2-car garage. It is rented by the licensee and contains a living room; kitchen; dining room, three bedrooms (1 primary), attached 2-car garage an enclosed (fenced) side and backyard area. The home is neat and clean with heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the one of the napping room, away from the other children in care.

On-limit-areas include: Living room (day care area); kitchen; dining room; two bedrooms for napping children; and main house bathroom at the end of the hall; main back yard patio area. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limit-areas include: The primary bedroom and attached bathroom; attached 2-car garage, front yard and southern side (gated) area of the back yard. The off-limit areas will be inaccessible by closed and/or locked doors, child gates and/or by child supervision.



There is a fireplace in the living room (day care area) with a fitted wood cover and blocked by a book case to prevent child access. Per licensee, there are no firearms in the home. A copy of the rental agreement was reviewed and a property owner notification form (LIC9151) has been issued.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 3A40BC fire extinguisher, working smoke and carbon monoxide detectors (tested and functioning), and a working telephone. Fire drills are conducted at least once every six months, the last drill was completed on 5/10/2023.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GUAN, RUIYANG
FACILITY NUMBER: 015700336
VISIT DATE: 09/06/2023
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
26
27
28
29
30
31
32
The licensee’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires 11/07/2024. Mandated Reporter has been completed and expires 11/05/2024. The licensee is in compliance with all immunization laws which pertains to day care providers. The licensee maintains childcare insurance through Markel Insurance Corporation, the policy is in force through 7/8/2024.

LPA reminded licensee of the following; CPR/1st aid training and Mandated Reporter certificates must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

Children’s files were reviewed, a copy of the roster was taken by the LPA for the office file. All files were complete and in good order. Sleep logs are maintained for infants, check and verified. Licensee reminded to maintain these logs for all infants up to 24 months and to save them for three years.

LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection.

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.

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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: GUAN, RUIYANG
FACILITY NUMBER: 015700336
VISIT DATE: 09/06/2023
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
26
27
28
29
30
31
32
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.

During the exit interview, licensee Ruiyang Guan confirmed there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

This home is recommended for an increase of capacity as of September 06, 2023. The report will remain on file for three years.

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

Exit interview conducted and report was reviewed with the licensee Ruiyang Guan.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4