015700350-5-12-2023-52-CC-MPRE-CRRTN7-20230512145217

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700350
Report Date: 05/12/2023
Date Signed: 05/12/2023 02:52:23 PM

Document Has Been Signed on 05/12/2023 02:52 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:	MEI, YUANYUAN		FACILITY NUMBER:	015700350
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 5	CENSUS: 4	DATE:	05/12/2023
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	11:47 AM
MET WITH:	YuanYuan Mei		TIME COMPLETED:	02:44 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 5/12/2023 at 11:57am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee YuanYuan Mei for an Announced Capacity Increase Inspection. Present during the inspection was the Licensee, her husband, Lin Gu, three (3) infants and two (2) preschool age children. One (1) infant belonging to the Licensee. Licensee lives in the home with her husband, their two sons aged four (4) and seven (7) months and her mother and father-in-law. Licensee’s home was toured for a health and safety inspection. The facility operates twenty-four (24) hours a day. ON LIMITS AREA: Kitchen, Dining Area, Living Room, 1^st Bedroom on the right side of the hallway, Hallway Bathroom and Backyard OFF LIMITS AREA: Master Bedroom and Bathroom, Bedroom on the left side of the hallway and Garage ISOLATION AREA: 1^st Bedroom on the right side of the hallway The home has gained a fire clearance on 4/28/2023 from the Hayward Fire Department. The facility is a single-story home owned by the Licensee. The home consists of a living room, kitchen, dining area, three (3) bedrooms, two (2) bathrooms, a two (2) car garage and backyard. The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, 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. Licensee stated that she does not provide transportation. There are no firearms and no pets in the home.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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 2

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: MEI, YUANYUAN	FACILITY NUMBER: 015700350
	VISIT DATE: 05/12/2023

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

There is one (1) fully charged 3A40BC fire extinguisher in the kitchen. There is one (1) working smoke detector in the dining area, the hallway and bedroom on the right side of the hallway. There is one (1) working carbon monoxide in the hallway. The fireplace in the living room is blocked by furniture making it inaccessible to the children in care. All cribs and play yards are free from defects and in proper working order. All napping and bedding equipment is properly stored and well maintained. All off limit areas are made inaccessible with gates and locks. The home is equipped with central heat and air for proper ventilation.

The backyard is fully fenced, clean, well maintained with ample age-appropriate materials for the children. There is a small in ground sandbox and one (1) that stores extra outside materials for the children. The shed is locked and made inaccessible to the children in care. There are also two (2) fruit trees. LPA did not observe any harmful bodies of water in or around the home.

Licensee’s Health and Safety training with lead poisoning component has been completed. Licensees’ Pediatric CPR and First Aid training is completed and expires 4/9/2024. Licensee’s Mandated Reporter is complete and expires 3/28/2024. LPA obtained the fire/disaster drill log, log is complete with the last drill logged 11/20/2023. All adults living, working, and volunteering in the home have obtained a criminal record clearance. All required forms are posted in the living room by the front door of the home.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

This home has been granted a capacity increase for a large family childcare home on 5/12/2023.

Exit interview conducted and report was reviewed with the Licensee YuanYuan Mei

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC809 (FAS) - (06/04)

Page: 2 of 2